Corneal topography system and methods

ABSTRACT

A mobile communication device-based corneal topography system includes an illumination system, an imaging system, a topography processor, an image sensor, and a mobile communication device. The illumination system is configured to generate an illumination pattern reflected off a cornea of a subject. The imaging system is coupled to an image sensor to capture an image of the reflected illumination pattern. A topography processor is coupled to the image sensor to process the image of the reflected illumination pattern. The mobile communications device includes a display, the mobile communications device is operatively coupled to the image sensor. The mobile communications device includes a mobile communications device (MCD) processor. A housing at least partially encloses one or more of the illumination system, the imaging system, or the topography processor.

RELATED APPLICATIONS

This application is a continuation of and claims priority to U.S.nonprovisional patent application Ser. No. 17/045,475, filed Oct. 5,2020, entitled “Corneal Topography Systems and Methods,” now U S. Pat.No. 11,096,573, which is a National Stage filing of and claims priorityto POT Application No. PCT/US2020/25957, filed Mar. 31, 2020, entitled“Corneal Topography Systems and Methods;” which claims priority to U.S.provisional patent application Ser. No. 62/977,701, filed Feb. 17, 2020,entitled “Corneal Topography System and Methods”; U.S. provisionalpatent application Ser. No. 62/890,056, filed Aug. 21, 2019, entitled“Mobile Communication Device-Based Corneal Topography SystemImprovements,”; and U.S. provisional patent application Ser. No.62/827,801, filed Apr. 1, 2019, entitled “Improvements in a MobileCommunication Device-Based Corneal Topography System,” the entiredisclosures and content of which are all hereby incorporated byreference.

BACKGROUND

Prior art corneal topography systems (which may be connected to a laptopcomputer or a desktop computer) project an image of Placido rings off ofa cornea of a human eye and into a digital imaging sensor (or one ormore digital imaging sensors). Some prior art systems are affixed to adesktop computer or may attach to a laptop computer, each of which maybe typically running a Windows operating system or a MAC operatingsystem. Prior art desktop-based or laptop-based corneal topographysystems may use an image sensor and a custom, proprietary imaging lenssystem designed to suit the desired parameters of the instrumentincluding field of view, focal length, and desired image magnificationto maximize use of the target commercial image sensor for its intendedpurpose.

A prior art corneal topography system attached to a smartphone isdescribed in “An Accessible Approach to Corneal Topography” by AndreLuis Beling da Rosa (“Beling da Rosa publication”) in December of 2013.The article describes a clip-on device with three layers: 1) anillumination layer to provide illumination of concentric rings; 2) asupport layer helping with the image captured using a lens and also withthe diffusion and 3) the pattern layer (which gives a shape to projectedpatterns). A smartphone clip-on device having three layers according tothe prior art as shown in pages 40 and 41 of the Beling da Rosapublication. However, this device was described as part of a PhD thesisfor a computer-science degree and was never commercialized. Anotherprior art corneal topography system attached to a smartphone isdescribed in “Design And Development Of An Ultraportable CornealTopographer For Smartphones As A Low Cost New Tool For PreventingBlindness Caused By Keratoconus” by Pinheiro et al (“Pinheiropublication”). This device includes a support cover, a printed circuitboard with LEDs (light emitting diodes), an optical system formagnification, a cone with transparent and black concentric rings(principle of Placido) and a dome. However, the Pinheiro publicationdoes not describe any details of an optical system. The Pinheiropublication device did not appear to have a system to confirm vertexdistance, so the device cannot internally calibrate. In at least someinstances with previous systems, an operator had to manually determinewhen the correct vertex distance was reached. In these previous systems,the operator could make mistakes and this resulted in poor image qualityor unfocused captured Placido rings (or other image pattern) images.

A need exists for a smartphone corneal topography system that is costeffective for a medical professional.

SUMMARY

In some embodiments, a mobile communication device-based cornealtopography system includes an illumination system configured to generatean illumination pattern reflected off a cornea of a subject; an imagingsystem coupled to an image sensor to capture an image of the reflectedillumination pattern; a topography processor operatively coupled to theimage sensor to process the image of the reflected illumination patternand a mobile communications device, the mobile communications deviceincluding a display. The mobile communication device may be operativelycoupled to the image sensor, the mobile communications device comprisinga mobile communications device (MCD) processor. In some embodiments, ahousing may at least partially enclose one or more of the illuminationsystem, the imaging system, or the topography processor.

In some embodiments, a mobile communication device-based cornealtopography system may include a mobile communication device comprising amobile communication device (MCD) processor and a display; a fixationbeam source to generate a fixation beam and direct the fixation beam tothe cornea of the subject, the fixation beam defining a fixation targetvisible to the eye of the subject, the fixation target beam comprising afirst wavelength of light; a ranging beam source to generate a rangingbeam and direct the ranging beam to a cornea of a subject, the rangingbeam comprising a second wavelength of light different from the firstwavelength of light; an imaging system coupled to an image sensor tocapture a reflected image of the ranging beam and the fixation beam onthe cornea; and a topography processor. In some embodiments, thetopography processor may be operatively coupled to the image sensor andconfigured with instructions to: determine when the ranging beam and thefixation beam are overlapping by tracking the first wavelength of lightand the second wavelength of light with spectral analysis anddetermining the fixation beam and the ranging beam are aligned with amark in a center of the reflected image; turn off the ranging beamsource and the fixation beam source; automatically capture, at the imagesensor, an image of a reflected illumination pattern reflected off thecornea of the subject; transmit the captured image of the reflectedillumination pattern to the topography processor; and process, by thetopography processor, the image of the reflected illumination pattern togenerate topography map images and one or more topography data files.

In some embodiments, an auto-capture method for use in cornealtopography systems may include capturing, at an image sensor, areflected image of a fixation beam at a first wavelength of light and aranging beam at a second wavelength of light on a cornea; communicatingthe reflected image of the fixation beam and the ranging beam to thetopography processor; communicating the reflected image of the fixationbeam and the ranging beam to a mobile communication device for display;spectrally analyzing, by the topography processor, the first wavelengthof light and the second wavelength of light to determine whether thefixation beam and the ranging beam are overlapping; determining that afiducial mark in a center of the reflected image is aligned with thefixation beam and the ranging beam; communicating instructions to turnoff the ranging beam and the fixation beam; and automatically capturing,at the image sensor, an image of an illumination pattern reflected offthe cornea of the subject.

In some embodiments, a system may calculate eye pupil measurements,including a first lens assembly having a rear surface and a frontsurface; a second lens assembly; a fixation light source to generate afixation light beam, wherein the fixation light beam is transmittedthrough the first lens assembly and the second lens assembly to apatient's cornea; and an infrared light source to generate an infraredlight beam. In some embodiments, the infrared light beam is reflectedoff the front surface of the first lens assembly and transmitted throughthe second lens assembly to the patient's cornea. In some embodiments,the infrared light beam and the fixation light beam are introducedon-axis to the patient's eye to be utilized in calculate eye pupilmeasurements.

In some embodiments, a mobile communication device-based cornealtopography system may include a custom-designed mobile communicationdevice, the custom-designed communication device may include a display,one or more memory devices, one or more processors and/orcomputer-readable instructions stored in the one or more memory devices,the computer-readable instructions including a custom-designed anddeveloped operating system to control operations of components of thecustom-designed mobile communication device. In some embodiments, acorneal topography system or housing, the corneal topography system orhousing including one or more memory devices, one or more processorsand/or computer-readable instructions stored in the one or more memorydevices, the computer-readable instructions also including thecustom-designed and developed operating system to control operations ofcomponents of the corneal topography system or housing.

INCORPORATION BY REFERENCE

All patents, applications, and publications referred to and identifiedherein are hereby incorporated by reference in their entirety, and shallbe considered fully incorporated by reference even though referred toelsewhere in the application.

BRIEF DESCRIPTION OF THE DRAWINGS

The patent or application file contains at least one drawing executed incolor. Copies of this patent or patent application publication withcolor drawing(s) will be provided by the Office upon request and paymentof the necessary fee.

A better understanding of the features, advantages and principles of thepresent disclosure will be obtained by reference to the followingdetailed description that sets forth illustrative embodiments, and theaccompanying drawings of which:

FIG. 1A illustrates a mobile communications device running a cornealtopography software application according to some embodiments;

FIG. 1B illustrates a screen of the corneal topography softwareapplication when a red ranging beam is not intersecting with areflection from a green fixation beam according to some embodiments;

FIG. 1C is an illustration of a display screen showing a red rangingbeam and a green fixation beam that have been activated and are seen ona video image of the patient's cornea according to some embodiments;

FIG. 1D illustrates a flowchart for the auto-capture process accordingto some embodiments;

FIG. 2 illustrates a screen of the corneal topography softwareapplication when the red ranging beam and the green fixation beamintersect or overlap according to some embodiments;

FIG. 2A illustrates a screen of the corneal topography softwareapplication when the red ranging beam and the green fixation beamintersect so as to overlap and produce an orange scatter beam accordingto some embodiments;

FIG. 2B illustrates a side view of a patient being examined by anexaminer utilizing a mobile communication device-based cornealtopography system according to some embodiments;

FIG. 2C illustrates a top view of a diagram of an autocapture systemaccording to some embodiments;

FIG. 2D illustrates a topography image of a ring pattern according tosome embodiments;

FIG. 3 illustrates a corneal topography system that includes IRillumination (e.g., an IR beam) and a green fixation beam being alignedon-axis into a patient's eye to detect pupil edges according to someembodiments;

FIG. 3A illustrate an image resulting from use retro illumination of thepupil for pupil edge detection according to some embodiments;

FIG. 4A illustrates a block diagram of corneal topography systemincluding system components for corneal topography at least partiallycontained within a housing (including a camera sensor) according to someembodiments;

FIG. 4B illustrates a ray drawing of a corneal topography systemincluding a single mirror design according to some embodiments;

FIG. 4C illustrates use of two mirrors for folding an image beam path ina corneal topography system according to some embodiments;

FIG. 5 illustrates an alternative embodiment utilizing a custom-designedand developed mobile communications device according to someembodiments;

FIG. 6A illustrates a side view of components of a mobile communicationdevice-based corneal topography system according to some embodiments;

FIG. 6B illustrates relationships of a number of planes and axes in amobile communication device-based corneal topography system according tosome embodiments;

FIG. 7A illustrates a top view of components and assemblies of a mobilecommunication device-based corneal topography system according to someembodiments;

FIG. 7B illustrates a front view of components and assemblies of amobile communication device-based corneal topography system according tosome embodiments;

FIG. 8 illustrates a side view of a mobile communication device-basedcorneal topography system including a housing according to someembodiments;

FIG. 8A illustrates that a corneal topography system may rotate about apivot axis in order to examine both eyes of a patient according to someembodiments; and

FIG. 8B illustrates a corneal topography system mounted on a slit lampmicroscope according to some embodiments.

DETAILED DESCRIPTION

The following detailed description and provides a better understandingof the features and advantages of the inventions described in thepresent disclosure in accordance with the embodiments disclosed herein.Although the detailed description includes many specific embodiments,these are provided by way of example only and should not be construed aslimiting the scope of the inventions disclosed herein.

FIG. 4A describes an embodiment where an image sensor or a camera sensormay be included or partially included as part of the corneal topographysystem or housing (containing the Keplerian telescope lenses and/or beamfolding mirrors) while residing on a custom-designed outboard printedcircuit board (PCB). In these embodiments the corneal topographysoftware may be stored in memory devices (e.g., ROM, firmware and/ornon-volatile memory) and the image sensor or camera sensor may beincluded on the topography-specific outboard PCB. In some embodiments,the mobile communication device is custom designed to use in the cornealtopography system and the operating system of the mobile communicationdevice is also a specific and custom designed to be maximally compatiblewith the corneal topography system. FIG. 5 illustrates an embodimentwhere the mobile communication device's camera may be utilized tocapture the Placido rings image reflected off of the cornea, thetopography (and image processing) software may be stored and executed onthe mobile communication device and where the mobile communicationdevice (and operating system) may be a custom-designed and fabricated tobe used in the mobile communication device-based corneal topographysystem.

FIGS. 1A, 1B, 1C, 1D and FIGS. 2, 2A, 2B, 2C, 2D and 2E describe anauto-capture process according to some embodiments that may be utilizedin the embodiments described above of the mobile communicationdevice-based corneal topography system. FIG. 3 describes an infraredillumination system utilized for pupil edge detection according to someembodiments that may be utilized in the embodiments described above ofthe mobile communication device-based corneal topography system.

This patent application begins with the description of the auto-captureprocess and follows with a description of the infrared illuminationsystem. In some embodiments, a mobile communication device-based cornealtopography system may comprise a mobile communication device and acorneal topography system or housing. The corneal topography system mayalso be referred to as a corneal topography optical bench or a cornealtopography housing in this disclosure. In some embodiments, the cornealtopography system may be mounted onto a post of a slit-lamp microscopeto allow adjustment in positioning of the mobile communicationdevice-based corneal topography system with respect to the patient beingexamined in an x-direction, a y-direction and a z-direction. In someembodiments, the z-direction may be moving the corneal topography systemcloser or farther from a patient being examined (e.g., movement in aforward or a backward direction). In some embodiments, the x-directionmay be moving the corneal topography system in a left or right directionwith respect to the patient being examined. In some embodiments, they-direction may be moving the corneal topography system in a up or downdirection with respect to the patient being examined.

In some embodiments, the mobile communication device may comprise one ormore processors, a display screen, one or more memory devices andcomputer-readable instructions stored and/or resident on the memorydevices. In some embodiments, the computer-readable instructions may beaccessed and executable by the one or more processors of the mobilecommunication device to initiate and execute a corneal topographysmartphone software application. In this embodiment, the mobilecommunication device may further communicate with one or external servercomputing devices (e.g., cloud-based servers) utilizing wirelesscommunication transceivers such as Wi-Fi transceivers, personal areanetwork transceivers, and/or other wireless cellular transceivers. Theseoperations are previously described in the U.S. patent and patentapplications referenced above.

FIGS. 1A to 1D describe operation of the auto-capture process accordingto some embodiments. In some embodiments, the corneal topographyapplication software (the corneal topography app) is resident on thesmartphone. In some embodiments, the corneal topography applicationsoftware may be stored in one or more memory devices of the mobilecommunication device and a remainder of the corneal topography softwaremay be stored in one or more memory devices of the corneal topographysystem. In some embodiments, one or more memory devices may be withinthe housing of the corneal topography system (e.g., on thetopography-specific PCB or outboard). In some embodiments, all of thecorneal topography software is not stored in the one or more memorydevices of the corneal topography system because the mobilecommunication device has at least the user interface software of theapplication software as well as other software components in order tointerface with the corneal topography system.

In some embodiments, a mobile communications device-based cornealtopography system is configured for the corneal topography software toautomatically capture a Placido rings image (or an image pattern)reflected off a patient's cornea when the mobile communication device(or image sensor) and the patient's eye are at the correct vertexdistance with respect to each other.

FIG. 1A illustrates a mobile communications device running a cornealtopography smartphone software application according to someembodiments. FIG. 1B illustrates a screen of the corneal topographysoftware application when a red ranging beam is not intersecting with agreen fixation beam according to some embodiments. FIG. 1C illustrates adisplay screen of the corneal topography software application when a redranging beam is not intersecting with a green fixation beam according tosome embodiments. FIG. 1D illustrates a flowchart for the auto-captureprocess according to some embodiments. FIG. 2 illustrates a screen ofthe corneal topography software application when the red ranging beamand the green fixation beam intersect or overlap and produce an orangescatter beam according to some embodiments. FIG. 2A illustrates a screenof the corneal topography software application when the red ranging beamand the green fixation beam intersect or overlap and produce an orangescatter beam according to some embodiments. FIG. 2B illustrates a sideview of a patient being examined by an examiner utilizing a mobilecommunication device-based corneal topography system according to someembodiments.

In some embodiments, the corneal topography smartphone application maybe initiated or started. In some embodiments, an image sensor in thecorneal topography system may initiate display of video images 110 of apatient's cornea which may be communicated to the mobile communicationdevice and presented on a mobile communication device display (e.g.,such as the corneal image displayed in FIG. 1A). In some embodiments, acommunication interface in the corneal topography optical system orhousing may communicate the obtained video corneal image to the mobilecommunication device (e.g., the corneal topography software applicationexecuting on the mobile communication device). In other embodiments, awireless communication interface may communicatively couple and/orconnect the corneal topography system or housing to the mobilecommunication device. As illustrated in FIG. 1A, in some embodiments,the mobile communication device 100 may include a display screen 105. Insome embodiments, the corneal topography application software mayinclude a screen or menu showing video images 110 of a patient's eye,including the iris, the pupil, the cornea and a lower section of thescreen or menu 115 where commands and text may be displayed or othermenu items may be displayed.

FIG. 1D illustrates a flowchart for the auto-capture process 150according to some embodiments. At a step 160, a camera initiates videoimage capture of a patient's cornea. At a step 165, a fixation lightsource and a ranging light source are activated. At a step 170, aslit-lamp microscope is adjusted to position an optical housing withrespect to a patient's eye. At a step 175 a ranging beam such as a redranging beam intersects and/or overlaps with a fixation beam such as agreen fixation beam. At a step 180, a software application detectsand/or identifies the overlap of the of the ranging beam and thefixation beam. At a step 185, a command is generated to turn of theranging beam and illuminate the cornea with a pattern such Placidorings. At a step 190, a camera automatically captures one or more imagesthe reflected pattern such as Placido rings. At a step 195, a softwareapplication processes the captured one or more images.

Although FIG. 1D shows a method in accordance with some embodiments, aperson of ordinary skill in the art will recognize many adaptations andvariations. For example, some the steps can be repeated, some of thesteps omitted, and the steps can be performed in any suitable order.Some of the steps may be performed sequentially, and some of the stepsmay be performed at substantially the same time, e.g. simultaneously. Insome embodiments, as illustrated in FIG. 1D, at step 165, a fixationlight source and/or a ranging light source in the corneal topographysystem may be activated. In some embodiments, the corneal topographysmartphone software application may communicate with the light sources(e.g., the ranging light source and the fixation light source) in thecorneal topography system or housing via the wired communicationinterface (e.g., a USB communication interface) to turn on the fixationlight source and/or the ranging light source. Alternatively, a cornealtopography smartphone application may communicate with a cornealtopography system or housing utilizing a wireless communicationsprotocol and interface (e.g., such as Bluetooth or Zigbee or WiFi orNear Field Communications (NFC)). In some embodiments, an operator oruser may utilize controls (e.g., switch(es) or button(s)) on the cornealtopography system or housing to activate the light sources (e.g., theranging light source and the fixation light source).

In some embodiments, a fixation light source may be a green LED and maygenerate a green light beam, although the fixation light source may emitlight of any visible wavelength or combination of wavelengths. In someembodiments, for example, a fixation light source may be a green LEDassembly. In some embodiments, a fixation light source may have awavelength of approximately 525 nanometers (+/−15 nm). In someembodiments, a fixation light source may be an OSRAM LTT64G-DAFA-29-0-20-R33-Z. In some embodiments, a ranging light source maybe a red LED or laser and may generate a red laser beam. In someembodiments, a ranging light source may be a red laser having awavelength of 650 nm (+/−15 nm). In some embodiments, a ranging lasermay be a Laserlands 3.5 mW 650 nm Red Laser Dot Module. Althoughreference is made to a red ranging light source, the ranging lightsource may comprise any suitable wavelength, such as visible,ultraviolet, infrared or near infrared light. In other embodiments,other light sources having different wavelengths may be utilized as longas the light beam utilized for the fixation beam and the light beamutilized for the ranging light beam may be distinguished from eachother. Alternatively, light of similar wavelengths may be used, and theranging light beam tracked with the application software until theranging light beam overlaps with the reflection of the fixation light.

FIG. 1B illustrates a video image of a patient's eye when a greenfixation beam and a red ranging beam are activated and projected onto apatient's cornea. In some embodiments, as is shown in FIG. 1B, the greenfixation beam 130 may be directed to a center portion of a pupil 123 ofthe eye because the patient may be focusing on the fixation light source(e.g., green light source). In some embodiments, the menu display of thevideo cornea image may also display a patient's eye 120, a white scleralportion 121 of a patient's eye, an iris 122 of a patient's eye and apupil 123 of a patient's eye. In some embodiments, the red ranging beam135 may be angled towards the patient's cornea (e.g., may be transmittedto the patient's cornea at a 45 degree angle). In some embodiments, thered ranging beam 135 may be directed towards the patient's eye at anangle of 30 to 60 degrees with respect to a front surface of thepatient's cornea. FIG. 1B illustrates an embodiment when alignment acorrect vertex distance to the corneal topography system has not yetbeen achieved, but the green fixation beam 130 and the red ranging beam135 have both been activated and are transmitted to a patient's corneaand are seen on the video image of the patient's cornea. FIG. 1Cillustrates an embodiment when a correct vertex has not yet beenachieved, but the green fixation beam 130 and the red ranging beam 135have both been activated and are transmitted to a patient's cornea andare seen on the video image of the patient's cornea along with acomputer generated marker such as a reticle. In some embodiments, thegreen fixation beam 130 may be at a center or near a center of the pupil123 in the video image. In some embodiments, the red ranging beam 135may not yet be inside the pupil 123 in the video image. In someembodiments, the reticle may be positioned in the video image of thepatient's pupil 123. FIG. 1C is an illustration of a display screenshowing a red ranging beam and a green fixation beam have been activatedand are seen on a video image of the patient's cornea according to someembodiments.

In some embodiments, an operator or medical professional may move atstep 170 a slit-lamp microscope in an x-direction, a y-direction or az-direction. In some embodiments, in moving the slit-lamp microscope ina z-direction, the operator or medical professional may be attempting todetermine or locate an ideal or correct vertex distance from an imagesensor or from a mobile communication device to the patient's cornea inorder to generate a focused image of the Purkinje image reflected fromthe patient's cornea. In some embodiments, the x-axis may be ahorizontal axis, the y-axis may be a vertical axis and the z-axis may bea distance from an image sensor or a mobile communication device'scorrect focal plane to the corneal vertex.

In some embodiments, as the slit-lamp microscope is moved (e.g., in az-axis direction), the red ranging beam 135 may intersect, overlap, orbe superimposed at step 175 with the green fixation beam 130 on a videoimage of a patient's cornea at a desired vertex distance. In someembodiments, an intersection of the green light beam and the red lightbeam may produce an orange scatter light on the patient's cornea whichcan be viewed or seen in the video image of the patient's cornea. Insome embodiments, the perceived orange scatter light comprises scatteredlight from the red ranging beam and reflected light from the greenfixation beam, corresponding to a region of overlap. FIGS. 2 and 2Aillustrate when the red ranging beam intersects with the green fixationbeam and produces an orange scatter beam 138 on a video image of thepatient's cornea. In this embodiment, the red ranging beam intersectsthe green fixation beam to produce the orange scatter beam 138 on thevideo image of the patient's cornea. In some embodiments, a size of anorange scatter beam 138 may not be larger than a size of the either thered ranging beam and/or the green fixation beam because the orangescatter beam is identifying when there is an intersection of the twobeams (e.g., the intersection of ranging beam and fixation beam).

In some embodiments, the corneal topography software (or a combinationof hardware and/or software) may detect or identify at step 180 theorange scatter beam on the displayed corneal video image. In otherwords, computer-readable instructions may be executable by one or moreprocessers on a topography-specific outboard or PCB in a cornealtopography system to determine when an orange scatter beam 138 ispresent on the displayed patient corneal video image (which identifiesthat the mobile communication device or the corneal topography imagesensor may be at the correct vertex distance from the patient's cornea).Although reference is made to an orange scatter beam, the instructionscan be configured to detect overlap the reflected fixation beam and thescattered ranging beam with any combination of wavelengths as describedherein.

In some embodiments, at step 185 the corneal topography softwareapplication may cause the mobile communication device to generate aninstruction, signal or command to turn off or deactivate the red rangingbeam 135 in the corneal topography system and to illuminate anillumination pattern in an illumination system (e.g., Placido rings inthe Placido ring illumination system). In some embodiments, anillumination pattern may be reflected onto a patient's cornea. In someembodiments, a Placido rings image may be reflected onto a patient'scornea. In some embodiments, the red ranging beam may be turned off soas to not interfere with the reflection of the illumination pattern(e.g., the Placido rings) on the patient's cornea. In some embodiments,the illumination pattern (e.g., the Placido rings pattern) may beilluminated at the same time that the green fixation beam and the redranging beam are activated in the corneal topography system. This may bepossible because the luminance value may not be high in the mobilecommunication device-based corneal topography system. In other words, insome embodiments, the intersection or overlap of the green fixation beamwith the red ranging beam (e.g., the produced orange scatter beam) maybe detected even if the illumination pattern is turned on (e.g., thePlacido rings are illuminated).

In some embodiments, the corneal topography software application maywait a predetermined time after the corneal topography softwareapplication determined that the red ranging light beam 135 hasoverlapped (or intersected or is superimposed) with the green fixationlight beam 130 in the video image of the patient's cornea. In someembodiments, the corneal topography software application may beverifying that the overlapping or intersection is a continuous or stableoccurrence and is not just an artifact or a temporary or fleetingintersection, overlapping, or superimposing of the red ranging beam withthe green fixation beam in the video cornea image. In these embodiments,this provides additional verification that the correct vertex distancemay be present.

In some embodiments, the corneal topography software application mayverify that the intersection of fixation light beam and the ranginglight beam occurs for a number of corneal image video frames beforeautomatically capturing a reflected illuminated pattern image (e.g.,Placido rings image) of a patient's cornea. In this embodiment, thecorneal topography software application may verify that a predeterminednumber of video frames have this intersection or overlapping of thegreen fixation beam and the red ranging beam in order to verify that thepatient or the corneal topography system (e.g., the corneal topographyoptical bench) is not moving and stability has been achieved. In someembodiments, the movement that is being referred to is the movement ofthe patient's eye relative to the corneal topography system or housing.In some embodiments, two or more successive corneal video images may bestored in a memory buffers (which may be circular or linear memorybuffers, or a circular video buffer) and the corneal topography softwareapplication may verify that superimposition or overlapping occurs inthese two or more video images (e.g., that the orange scatter beam ispresent in the two or more corneal video images).

Although reference is made to the ranging beam overlapping with thefixation beam in the image, in some embodiments, the processorinstructions are configured to initiate the illumination pattern andimage capture when the fixation beam and the ranging beam aresufficiently close in the image and not yet overlapping.

At a step 190, the camera automatically captures the image of thepattern reflected from the cornea, e.g. the Placido rings.

In some embodiments, the corneal topography software application mayprocess at step 195 the automatically captured illuminated pattern image(e.g., Placido rings image) and further generate additional relatedcorneal topography images (e.g., a Placido ring edge detection image)and/or datafiles. For example, the corneal topography softwareapplication may generate a corneal topography power map and/or apatient's corneal topography data file. In some embodiments, the cornealtopography software functionality may be performed in the cornealtopography system or housing (e.g., by computer-readable instructionsexecutable by one or more processors of the corneal topography system),and the resulting images and related parameters may be communicated ortransmitted, via the communication interface or communication circuitryto the mobile communication device, and the resulting images may begenerated and presented on the display of the mobile communicationdevice.

Although the description above identifies that the functions of thecorneal topography software may be performed by components partiallycontained within the corneal topography system (e.g., bycomputer-readable instructions executable the one or more processors),in some embodiments, some components or modules of the cornealtopography software functionality may be performed on the mobilecommunications device and the resulting images may be communicatedand/or transmitted to a cloud-based server. In some embodiments, thecorneal topography software of the corneal topography system may onlycapture the reflected illuminated pattern image (e.g., Placido ringsimage) and the additional corneal topography image processing may beperformed on a cloud-based server (after the reflected illuminatedpattern image (e.g., Placido rings image) has been communicated to themobile communication device and then to the cloud-based server). As willbe discussed with respect to FIG. 4A, corneal topography software storedin the one or more memory devices of the corneal topography system orhousing may perform the automatic capture of the reflected Placido ringsimage as well as perform the resulting corneal topography imageprocessing (e.g., generating a Placido ring edge detection image, one ormore patient data files and/or corneal topography power map) in order toreduce the processing requirements on the mobile communication deviceand/or also to maintain tighter control of the mobile communicationdevice-based corneal topography system (e.g., there is no need to worryabout changes in the mobile computing device software or drivers whichcould cause problems with the corneal topography system).

While the above disclosure specifies a green fixation light beam, a redranging light beam and an orange scatter beam, the embodiments disclosedherein are not limited to these color light beams and/or wavelengths.Different color light beams or wavelengths may be utilized for thefixation light beam and different color light beams or wavelengths maybe utilized for the ranging light beam. In some embodiments, onequalification would be that a color of the fixation light beam has to bea different color or wavelength than a color or wavelength of theranging light beam in order for a user, operator, software or system tobe able to detect when the fixation light beam and the red ranging beamare overlapping or intersecting. In some embodiments, the color orwavelength selected for the ranging light beam and the color orwavelength selected for the fixation light beam may have to be visiblein the video display on the mobile communication device in order for theuser, operator or software to detect its presence. In other words, thecolor or wavelength of the fixation light beam and/or the ranging lightbeam could not be a same color as the subject's iris or pupil. In someembodiments, the light-scatter beam may be the additive result of theselected fixation light beam color or wavelength and the selectedranging light beam color or wavelength. For example, in someembodiments, if the ranging light beam was a blue light beam and thefixation light beam was a red light beam, the light-scatter beam createdby the intersection or overlapping of the ranging light beam and thefixation light beam may be purple light scatter, although the claimedsubject matter is not limited to the above-described example. In someembodiments, the light scatter triggering auto-capture would beanalyzing the video image to identify when the light scatter beam is theadditive color of the ranging light beam and the fixation light beam.

In some embodiments, the ranging beam may be referred to as an alignmentbeam. In some embodiments, the image sensor may be referred to as acamera sensor or a detector. In some embodiments, a system includingauto-capture may comprise a fixation target beam, an alignment beam, adetector, and a processor coupled to the detector. In some embodiments,the illumination pattern may be reflected from the cornea. In someembodiments, the fixation target beam may define a target visible to aneye and the fixation target beam may comprise a first wavelength oflight. In some embodiments, the alignment beam may be focused to a beamwaist at a location overlapping with the fixed target beam, thealignment beam comprising a second wavelength of light different fromthe first wavelength of light. In some embodiments, the detector mayimage or capture an image of the reflection of the target beam and thealignment beam from the cornea. In some embodiments, the processor maybe coupled to a detector and the processor may be configured withinstructions to display an image of the eye with a portion of the imageshowing the fixation beam overlapping with the alignment beam. In someembodiments, the processor may be configured with instructions toilluminate the illumination pattern and capture an image of theillumination pattern reflected from an anterior surface of the cornea inresponse to a reflection of the fixation beam overlapping the alignmentbeam.

In some embodiments, the alignment beam may be configured to overlapwith the fixation beam at a vertex of the cornea. In some embodiments,the fixation beam may comprise substantially collimated light prior toreflection from the cornea. In some embodiments, the image of thefixation beam from an anterior surface of the cornea comprises a maximumsize across within a range from about 10 um to about 1 mm. In someembodiments, the fixation beam may be collimated to within about 45degrees. In some embodiments, the alignment beam may be focused to thewaist at a full cone angle within a range from about 1 degree to 45degrees.

In some embodiments, the detector may comprise an array of pixels, andthe array of pixels may comprise a first plurality of pixels moresensitive to the first wavelength than the second wavelength and asecond plurality of pixels more sensitive to the second wavelength thanthe first wavelength. In some embodiments, the first wavelengthcomprises a first color and the second wavelength comprise a secondcolor different from the first color. In some embodiments, the processormay be configured with instructions to display a portion where the firstbeam overlaps with the second beam with a different color than the firstwavelength and the second wavelength. In some embodiments, the image ofthe alignment beam may comprise an image of scattered life from thecornea when a tear fil covers the cornea. In some embodiments, thescatter light may comprise light scattered from a Bowman's membrane or astroma of the eye beneath a tear film of the eye. In some embodiments,the alignment beam may extend along an alignment beam axis at an obliqueangle to an axis of the fixation beam.

FIG. 2C shows alignment of the eye with a ranging beam such as a laserbeam focused on the cornea, in accordance with some embodiments. In someembodiments, an eyecup 223 comprises a first aperture 225 to pass theranging laser beam and a second aperture 232 to pass the scattered light234 from ranging laser beam. The laser beam 226 may comprise a laserbeam from any suitable laser source such as a laser diode 228. Lightfrom the laser source may be passed through a lens 227 to focus thelaser beam to a waist near the cornea 221. In some embodiments, thelaser beam is inclined relative to the optical axis of the system at anysuitable angle, such as an angle from about 20 degrees to about 60degrees, such that the laser beam spot moves across the cornea 221 asthe topography system moves relative to the eye along the optical axis(Z-axis) 236, as described herein. Prior to measuring the eye, the laserbeam angle may be adjusted to cross the optical axis where the vertex ofthe cornea is to be positioned when aligned with the topography systemalong the optical axis. The laser beam 226 may also be focused where itcrosses the optical axis 236, so as to decrease the spot size andimprove positioning accuracy. In some embodiments, when the vertex ofthe cornea is positioned along the optical axis at the intended positionalong the optical axis, the focused waist of the laser beam 226 mayappear as a spot of light in the camera image so as to overlap with theimage of the reflection from the fixation light as described herein. Insome embodiments, the focus of the laser beam at the location where thebeam crosses the optical axis may be sufficiently small to allowaccurate alignment of the eye along the optical axis and can be focusedto any suitable size, for example within a range from about 10 micronsto about 100 microns, Although reference is made to a beam waist, thefocused spot need not comprise a diffraction limited spot, and the beamwaist may correspond to an image of the output aperture of the laserdiode 228, for example. In some embodiments, the light from the focusedlaser beam is back scattered from the cornea generally along the opticalaxis towards the second aperture 232 and the imaging optics of thecorneal topography system. In some embodiments, the topography imagesmay comprise the scattered light 234 from focused laser beam 226illuminating the cornea. In some embodiments, the laser beam lightreflected from the cornea 221 with specular reflection 235 (i.e. mirrorlike reflection) may be reflected from the tear film on the anteriorsurface of the cornea 221 at an angle to the optical axis similar to theangle of the laser beam toward the cornea but in an opposite direction.This specular reflected laser beam light 235 may be blocked by theeyecup 223 or other suitable structure. This reflection of the specularlight away from the second aperture 232 can improve the contrast of theimage of the scattered light from the cornea. In some embodiments, theeyecup 223 comprises the first aperture 225 to pass the laser beam. Thesecond aperture 232 is sized to pass the fixation beam, the pattern ofreflected light from the cornea in order to image the pattern with thecamera, the scattered light 234, and the fixation beam reflected fromthe cornea. The illumination pattern 233 is passed through the secondaperture 232 so as to form the Purkinje image 222 comprising light fromthe illumination pattern 233 and the fixation beam 231 as describedherein.

In some embodiments, the Purkinje image of the illumination pattern islocated farther from the cornea than the Purkinje image of the reflectedfixation beam. In some embodiments, the location of the Purkinje imagevaries with the distance of the object reflected from the cornea. Forobjects that are located closer to the cornea and reflected from theeye, the Purkinje image is located farther from the cornea. For objectsthat are farther from the eye, the Purkinje image is located closer tothe cornea. The fixation beam may comprise a substantially collimatedbeam of light that corresponds to an object far from the eye, e.g.approximating infinity. The illumination pattern reflected from the eyecorresponds to a distance from the cornea that is closer to the corneathan the reflected fixation beam, and he Purkinje image of theillumination pattern is located farther from the cornea than thePurkinje image of the reflected fixation beam.

The components, structures and features shown with reference to FIG. 2Ccan be combined with embodiments of the topography system as describedherein. For example, in some embodiments, a fixation beam 231 may passthrough the second aperture 232 that receives the scattered light 234from the cornea. In some embodiments, the eyecup 223 may comprise anysuitable illumination pattern such as Placido disks, point sources oflight, point sources of light arranged along circles to approximate aPlacido disk, or a grid pattern, for example. In some embodiments, theillumination pattern 233 is configured to reflect from the cornea form aPurkinje image 222 (virtual image), such as the first Purkinje image 222at a location below the cornea. The fixation light beam 231 may compriseapproximately collimated light that reflects from the cornea to form aportion of Purkinje image 222 that forms near the center of the Purkinjeimage of the illumination pattern as described herein. In someembodiments, the scattered laser light 234 from the cornea 221 overlapswith the Purkinje image of the fixation beam 231 near the center of theillumination pattern as described herein.

FIG. 2D illustrates a topography image 299 produced by the mobilecommunications device-based corneal topography system. In someembodiments, a light pattern 297 comprises rings of concentric circlesof varying diameters. The size, shape and location of the light patternis related to the shape of the cornea and can be used to derive cornealtopography data. For example, with steeper corneas the light pattern issmaller in the camera image and with flatter corneas the light patternis larger. With astigmatic corneas, the light pattern can be distorted,being larger in one direction and smaller in another direction.

In some embodiments, the fixation beam Purkinje Image 296 is smaller andinside of the smallest boundary of the pattern, such as a circle 298.

The light pattern reflected from the cornea can be shaped and processedin many ways. In some embodiments, the light pattern comprises aplurality of continuous rings of light, such as a rings of a Placidodisk. Each of the continuous rings can be processed with imageprocessing to determine a plurality of discrete points corresponding toa plurality of locations of each ring. Alternatively, the light patternmay comprise a plurality of discrete light sources located along circlescorresponding to rings of a Placido disk, and the locations of each ofthese light sources determined. The light pattern locations may bederived from the rings or the discrete sources of the light pattern inorder to generate the corneal topography data. The light patternlocations may corresponds to a plurality of concentric circles withdeceasing diameters. In some embodiments, a plurality of LED lightelements may form and/or generate the light pattern.

In some embodiments, the image of the fixation beam may overlap with thealignment beam which may include the second wavelength of light from thealignment beam scattered from the cornea and the first wavelength oflight from the fixation beam reflected from the cornea. In someembodiments, a distance across the alignment beam on the cornea may bewithin a range of 5 microns to 200 microns, optionally within a range of10 microns to 150 microns, or optionally within a range of 20 microns to100 microns. In some embodiments, a distance across the fixation beam ina Purkinje image of the eye may be within a range of 10 microns to 300microns, optionally within a range of 25 microns to 200 microns, oroptionally within a range of 50 to 150 microns.

In some embodiments, a reticle may be displayed on the mobilecommunication device screen to facilitate alignment, for example whenthe alignment beam overlaps the fixation beam. While the beams can besized in many ways, the overlapping area of the beams in the image maycorrespond to a distance across the cornea within a range of 10 micronsto 200 microns, optionally a range of 15 microns to 125 microns, oroptionally a range of 20 microns to 75 microns.

In some embodiments, the illumination system may include a Placido ringassembly comprising a plurality of rings, wherein an innermostconcentric ring of the camera image has a larger diameter than adistance across the fixation beam, or a distance across the rangingbeam. In some embodiments, the illumination system may include a Placidoring assembly including a plurality of concentric rings, wherein theplurality of concentric rings is formed by a plurality of light-emittingdiodes (LEDs) at discrete separated locations along a plurality ofcircles. In some embodiments, the illumination system may include aPlacido ring assembly including a plurality of concentric rings, whereinthe plurality of concentric rings is formed by a geometry of a Placidoring component, and the Placido ring component may be illuminated by aplurality of light-emitting diodes (LEDs). In some embodiments, in thecorneal topography system, the luminescence intensity of pattern fromthe illumination system at the cornea may be within a range from 10 luxto 500 lux, optionally from 25 lux to 250 lux and optionally from 50 luxto 125 lux In some embodiments, the illumination system may comprise orinclude a Placido ring assembly comprising a plurality of concentricrings, the plurality of concentric rings emitting a third wavelength oflight, the third wavelength of light different from the first wavelengthof light, e.g. of the fixation beam, and the second wavelength of light,e.g. of the ranging beam. In some embodiments, when a patient is beingexamined on the mobile communication device-based corneal topographysystem, the eye of a patient looks downward from horizontal at an anglewithin a range of 2.5 degrees to 15 degrees towards the fixation targetbeam, or optionally looks downward a range of 5 degrees to 10 degreestowards a fixation target beam. In some embodiments, the alignment beammay be inclined relative to an optical axis and focused to across-sectional size on the cornea to position the vertex of the corneaalong the optical axis with an error of no more than 150 microns whenthe fixation beam overlaps with the alignment beam in the image, andoptionally wherein the error is no more than 100 microns, optionally nomore than 50 microns and optionally no more than 25 microns. In someembodiments, when a patient is being examined on the mobilecommunication device-based corneal topography system, the eye of apatient looks at a fixation target beam along a horizontal axis. In someembodiments, when a patient is being examined on the mobilecommunication device-based corneal topography system, the eye of apatient looks down at an angle from horizontal within a range of 0.1 to2.5 degrees towards the fixation beam.

Referring again to FIG. 2B, the mobile communications device-basedcorneal topography system may comprise one or more ergonomicconfigurations, according to some embodiments. In some embodiments, thepatient looks downward at an angle 890 relative to horizontal toward thefixation target embodiments, an additional design consideration may bethat an image of a subject's cornea on the mobile communication device'sdisplay (e.g., the reflected image) be positioned at a downward anglewith the horizontal line connecting an examiner and an examinationsubject (or patient). A term of art used by movie directors andcinematographers that pertains to this may be referred to as “eye line”.That is an imaginary line connecting the eyes of two actors in a scene.In a corneal topography system, an “eye-line” between an examiner and asubject has traditionally been in a horizontal plane. The “eye-line”refers to a condition where the eye of the examiner should be alignednear a horizontal plane with the eye of the subject being examined. FIG.2B illustrates a horizontal eye line 256 between an examiner and anexamination subject. The line between the examiner's eye 282 and theimage of the cornea on the mobile communication device display is in adownward direction. In other words, the examiner is looking downward tothe corneal image as is illustrated by the line identified as angle 899relative to horizontal. In embodiments of a mobile communicationdevice-based corneal topography system, it may be preferable to have acorneal topography image on the mobile communication display bereasonably aligned both horizontally and vertically such that theeye-line passes through a center of a live camera image of mobilecommunication device display. In some embodiments, the examiner may lookalong a horizontal axis towards the image on the mobile communicationdevice display. In some embodiments, the examiner may look down at anangle from horizontal within the range of 0.1 to 2.5 degrees towards thedisplay of the mobile communication device.

This allows ease-of-use for an examiner in that it may maintains thesame or similar horizontal plane eye-line relationship that existed whenthe Examiner utilized the slit-lamp microscope. In other words, theexaminer is used to such a horizontal plane eye-line positioning whenthe examiner operates the slit-lamp microscope. In some embodiments, themobile communication device-based corneal topography system, which isattached to the slit-lamp microscope, does not change this horizontalplane eye-line relationship. In some embodiments, Aa mobile computingdevice-based corneal topography system may comprise a bulkhead and aslit lamp mounting plate and/or mounting assembly according toembodiments. In some embodiments, a bulkhead or positioning plate may beutilized to align and/or attach other pieces of a smartphone-basedcorneal topography system in place in order to enable efficientoperation. In some embodiments, a bulkhead or a positioning plate mayinclude a recess for a Placido illumination system 267 and/or eye piece258. In some embodiments, a mounting assembly (e.g., a positioning platemay attach to an optical bench or corneal topography optical housing)may be utilized to connect to a slit lamp microscope mounting assembly.In embodiments, a mobile communication device-based corneal topographysystem may be attached (or piggy-backed) onto a slit-lamp microscope inorder to maintain examination accuracy.

In some embodiments, a mobile communication device-based cornealtopography system may also utilize infrared (IR) illumination (or asimilar wavelength illumination to enable or initiate pupil edgedetection. In some embodiments, the IR beam is transmitted through thepupil and reflected from the retina, such that the pupil of the eyeappears lighter than the iris. This retro-illumination of the pupil canfacilitate detection of the edge of the pupil. FIG. 3 illustrates acorneal topography system or housing that includes IR illumination(e.g., an IR beam) and a green fixation beam being aligned on-axis intoa patient's eye according to some embodiment. In some embodiments, theon-axis alignment of the infrared illumination and green fixation beammay allow for edge detection of a patient's pupil during dark conditions(e.g., without the Placido rings being illuminated) (scotopicconditions), during medium light conditions (mesopic conditions) andduring light conditions—photopic conditions (e.g., with the Placidorings being illuminated). In other words, the corneal topographysoftware application may generate pupil edge measurements in lightand/or dark conditions. In some embodiments, the IR light source mayintroduce the infrared beam coaxially, aligned with the green fixationbeam and on axis with a patient's line of sight. In some embodiments, anadvantage of coaxial illumination of the IR beam and the green fixationbeam is that an operator and the corneal topography smartphone softwaremay image the “red reflex” (retro-illumination) and see opacities in anoptically significant part of the patient's visual system (e.g., acentral ˜6 mm diameter of the cornea and lens, which is an approximatemeasure depending on a patient's pupil size). This advantage may be inaddition to the coaxial alignment of the infrared beam and greenfixation beam allowing the corneal topography software application toimage the pupil edge for pupil size measurement in dark and lightconditions.

In FIG. 3, in some embodiments, the corneal topography system or housingmay include a fixation source (e.g., green LED) 305, an infrared lightsource 310 (IR LED), a first lens assembly 315, a second lens assembly320, and/or a doublet 335. In some embodiments, the green fixationsource 305 may a green LED that transmits a green fixation beam 325. Insome embodiments, the green fixation beam 325 may be transmitted on axisto a patient's eye, as is illustrated in FIG. 3. In some embodiments,the green fixation beam 325 may be transmitted through a first lens 315,which may be a tilted lens. In some embodiments, the first lens 315 maybe tilted which may introduce an astigmatism in the green fixation beam.In some embodiments, the green fixation beam 325 may then pass through asecond lens 320, which may be a tilted lens. In some embodiments, thesecond tilted lens may correct for the astigmatism introduced by thefirst lens 315. In some embodiments, the green fixation beam 325 maypass through a doublet 335 on its way to the patient's cornea. In someembodiments, an infrared light beam 326 may be introduced in front ofthe first lens 315 and reflects off of the front surface of the firstlens 315. In some embodiments, the infrared light beam 340 may passthrough or be transmitted through the second lens 320 and/or the doublet335 to the patient's cornea. In some embodiments, the infrared lightsource 310 may cast diffuse infrared light onto the patient's pupil inorder to the illuminate the patient's pupil at an infrared spectrum.Because, the infrared light beam 326 may be diffused, the system may nothave to correct for an astigmatism. In some embodiments, the infraredlight source may be an LED having a wavelength of 780 nm (+/−15 nm). Insome embodiments, the infrared light source may be a Thorlabs LED780E.In some embodiments, the light source may generate a light beamsubstantially close to infrared light spectrum as long as the lightsource illuminates the subject's eye.

In some embodiments, in order to perform pupil edge detection, thefixation light source (e.g., green LED) 305 and the infrared lightsource 310 may be activated and/or turned on. In some embodiments, thegreen fixation light source 305 and the infrared light source 310 may beactivated by an operator turning on switches or controls of the cornealtopography system or housing. In some embodiments, computer-readableinstructions executable by one or more processors on a topographyoutboard or PCB of a corneal topography system or housing may causesignals to be transmitted to the fixation light source 305 and theinfrared light source 310 in order to turn on the fixation light source305 and/or the infrared light source 310. In some embodiments,computer-readable instructions executable by one or more processors onthe mobile communication device may cause signals, commands and/orinstructions to be transmitted to the corneal topography system orhousing to activate or turn on the fixation light source 305 and theinfrared light source 310. Although FIG. 3 illustrates a first lens, asecond lens and a doublet, other optical components may be utilized bythe corneal topography system in order to direct the green fixation beamand/or the IR beam to the patient's cornea. Although FIG. 3 and thediscussion above identifies an IR beam and a green fixation beam, otherwavelengths and/or colors may be utilized in place of or in addition tothe IR beams and green fixation beams as long as these other light beamsare detectable in light and/or dark conditions and illuminate the eye.

FIG. 3A illustrate results of utilization of the IR illumination systemfor pupil edge detection according to some embodiments. As isillustrated in FIG. 3A, the patient's pupil 360 may be illuminated byinfrared illumination, which is reflected from the retina, such that thepupil appears lighter than the iris. In FIG. 3A, the eye may be in adark or non-illuminated setting or environment. In some implementations,the eye may include an iris 355, a pupil 360, a reflected illuminationpattern 365 (e.g., a reflected Placido ring pattern), and a pupililluminated by an infrared light source as described herein. Work inrelation to the present disclosure suggests that retro-illumination ofthe pupil is well suited for combination with smart phone cameras asdescribed herein, because the retro illumination of the pupil provides asufficiently bright pupil for the edge of the pupil to be readilyvisible in the camera image, and the smart phone camera may comprisesufficient sensitivity to wavelengths that are barely perceptible orsubstantially imperceptible by the human eye to make the pupil readilyvisible in the camera image, such as wavelengths from about 750 to 850nm.

Although reference is made to edge detection with retro-illumination ofthe pupil, an IR light source can be used to illuminate the iris anddetect the pupil without retroreflection. For example, IR light sourcesto transmit light obliquely toward the cornea so as to illuminate theiris and detect the boundary between the iris and the pupil.

In some embodiments, the iPhone 7-Plus is a high-end mobilecommunication device that includes a high-end camera, a high-end lensand image processing hardware and/or software. Even with a high-levelmobile communication device platform, (such as the Apple iPhone 7 andother similar Android-based smartphones made by Motorola and Samsung),the mobile communication device may have tiny variations in lensposition relative to the mobile communication device camera sensor. Forexample, this is true with the Apple iPhone7. In addition, thehigh-level mobile communication device platforms also have very tinyvariations in adjustment needed to set (or lock) focus and/or zoomoptimally for the corneal topography system Keplerian telescope systemresident or installed in the corneal topography system or housing.Accordingly, individual measurements or settings may need to be made foreach individual mobile communication device (e.g. iPhone)camera-and-lens subsystem. Then, individual .ini files (e.g.,configuration files) may need to be created for each individual mobilecommunication device to incorporate those unique settings. Such a setupand/or requirement is not useful in a production or manufacturingenvironment because time and/or resources would be necessary to measurethe variations in the cameras and/or lens of the mobile communicationdevice and then to record or store the identified settings forutilization later in configuring the corneal topography system.

In a new and novel embodiment, as illustrated in FIG. 4A, a newconfiguration of a mobile communication device-based corneal topographysystem includes moving an image sensor, one or more processors, one ormore memory devices and/or image processing hardware and software intothe corneal topography system or housing. In some embodiments, the imagesensor (or camera sensor), one or more processors, one or more memorydevices and image processing hardware and/or software may be installedon one or more printed circuit boards (PCBs) or an outboard, and thePCBs or outboard may be installed in a corneal topography system orhousing. The specification herein refers to a topography-specific PCB ora topography-specific outboard, but this apparatus may also be referredto as a topography outboard, a topography-specific chipset, or atopography-specific system on a chip (SoC). In some embodiments, thetopography-specific PCB or outboard may be a single printed circuitboard and/or maybe two or more PCBs coupled or connected to each other.In addition, the topography-specific PCB or outboard may also havecomponents or assemblies that perform other functions including having acommunications interface (e.g., such as a USB or Ethernet communicationinterface). In some embodiments, while the specification refers to acorneal topography system or housing, the image sensor, one or moreprocessors, one or more memory devices, the image processing hardware orsoftware, and/or other components or assemblies may be i) installed,located or positioned within a single physical housing or multiplephysical housings or ii) have some of the image sensor, one or moreprocessors, one or more memory devices, the image processing hardware orsoftware, and/or components or assemblies mounted, attached, coupled orconnected to one or more physical housings. In other words, thedescription herein is not limited to all of the above listed devices,components or assemblies being located within one physical cornealtopography housing. For example, in some embodiments, some of thedevices, components or assemblies may be partially contained within thecorneal topography housing and others may be completely contained withinthe corneal topography housing. For example, in some embodiments, someof the devices, components or assemblies may be partially containedwithin one or more corneal topography housings while others are attachedto, coupled to or connected to other devices, components and/orassemblies that are not within corneal topography housings.

In some embodiments, the image sensor (or camera sensor) and othercomponents (e.g., processors, image processors, memory devices,computer-readable instructions, etc.) may be mounted on a circuit board.In some embodiments, a circuit board may be mounted to a rear surface ofcorneal topography system or housing, although the location of thecircuit board may not be limited a rear surface. In some embodiments,the image sensor (or camera sensor) may be installed in a position thatis a horizontal center of the rear surface of the corneal topographysystem or housing and may also be directly be aligned with a rest of theslit-lamp microscope which is aligned with the corneal topographysystem. In some embodiments, the image sensor (or camera sensor) may beinstalled in other positions and on other surfaces besides a horizontalcenter of a rear surface. Accordingly, the specification does not limitthe location of the image sensor (or camera sensor) within the cornealtopography system or housing as the location of the image sensor may bewithin any location of the corneal topography system or housing.

FIG. 5, which will be described later, may utilize the mobilecommunication device camera rather than the image sensor (or camerasensor) of the corneal topography system of FIG. 4A. However, in FIG. 5,because the mobile communication device may be designed, customizedand/or fabricated for the corneal topography system, any variations inthe lens position and/or the adjustments for focus and/or zoom may beeliminated because the mobile communication device camera sensor will beaffixed at the exact focal plane of the Keplerian telescope system ofthe corneal topography system, eliminating the standard lens typicallyinstalled in front of the camera sensor in most modern mobilecommunication device. Additionally, the mobile communication device maybe be manufactured according to custom specifications provided by themaker or developer of the mobile communication device-based cornealtopography system.

FIG. 4A illustrates a block diagram of a corneal topography systemincluding system components (including an image sensor or camera sensor)for corneal topography at least partially contained within a housingaccording to according to some embodiments. In some embodiments, asillustrated in FIG. 4A, the corneal topography system 407 may beconnected, coupled or attached to a custom-designed and fabricatedmobile communication device 470. In some embodiments, the cornealtopography system 407 may be positioned adjacent to a surface of themobile communication device 470 and may be connected via a ribbon cable(e.g., a USB-3 ribbon cable). In some embodiments, the cornealtopography system or housing 407 may be connected or coupled to a slitlamp microscope mount 475 to allow adjustment of the corneal topographysystem or housing with respect to the patient's eye. In someembodiments, as illustrated in FIG. 4A, the corneal topography system orhousing 407 may comprise a power supply 411, an image path 412, acommunications interface or communications processor 425, atopography-specific PCB or outboard 412, a Placido ring illuminationcontrol system 450, a fixation light source 452, an infrared lightsource 453 and/or a ranging beam light source 451. In some embodiments,the corneal topography system or housing 407 may further comprise anillumination system 457 (e.g., a Placido rings illumination system)and/or a rest 458. In some embodiments, a patient's head may rest on achin rest of the slit lamp microscope with a curved plastic strap toposition the forehead against the corneal topography system. In someembodiments, fixating the chin and forehead may allow for stabilizationof the head relative to the microscope (and thus the corneal topographysystem.) In some embodiments, the illumination system 457 (e.g., Placidoring illumination system) may include one or more lights (e.g., LEDs) toilluminate a specific pattern that may be reflected off of a patient'scornea. In some embodiments, the custom-designed or fabricated mobilecommunication device 470 may comprise one or more processors, one ormore memory devices, operating system software, application software, adisplay and/or a communication interface 425. In addition, although notshown in FIG. 4A, the mobile communication device 470 may also includeGPS transceivers, cellular transceivers (3G, 4G, or 5G), wireless localarea network (Wi-Fi) transceivers, NFC transceivers, and/or othercomponents and/or software. In some embodiments, as illustrated in FIG.4A, the topography-specific PCB/outboard or control circuitry 412 maycomprise an image processor 440, one or more processors 415, one or morememory devices 416, computer-readable instructions stored in the one ormore memory devices 417 and/or firmware 418. In some embodiments, thetopography-specific PCB or outboard 412 may comprise communicationcircuitry and/or a communication interface 425. The topography-specificPCB or outboard 412 may not be required to utilize or include all thecomponents or assemblies illustrated in FIG. 4A. For example, in someembodiments the one or more processors 415 may include image processingcapability (and so a separate image processor may not be needed). Insome embodiments, for example, the one or more memory devices 417 mayinclude all the driver and/or application software and firmware 418 maynot be needed in certain embodiments of topography-specific PCB oroutboard.

In this new and novel corneal topography system or housing, an imagingsubassembly (which includes Keplerian telescope lenses and/or beamfolding mirrors) may reflect a Placido rings image on a patient's corneaand the image sensor (or camera sensor) 410 may capture a reflectedPlacido rings image (or an image of another illuminated pattern). Insome embodiments, because the image sensor (or camera sensor) 410 may beplaced at a specific position and because the imaging subassembly andresulting imaging path 430 may have specific dimensions, the reflectedPlacido rings image (or image of another illuminated pattern) may bereceived at the image sensor or camera sensor 410 at a corneal imageplane at a desired vertex distance from the patient's eye (or cornea).In some embodiments, the Placido rings image (or image of anotherilluminated pattern) may be reflected or projected into the camerasensor without using any type of zooming functionality. In someembodiments, the image sensor, camera sensor or detector may be aCMOS-sensor or may be a CCD sensor (such as a Sony IMX250 CMOS sensor).

In some embodiments, a Keplerian telescope of the corneal topographysystem may project a Placido rings image directly into the image sensoror camera sensor without interposing a standard camera lens on an outerhousing of a mobile communication device in front of the camera sensor.In some embodiments, the zoom may be set and defined by the opticalcomponents of the Keplerian telescope system. In some embodiments, thezoom may not able to be tweaked or altered by any adjustment of themobile communication device camera optical zoom settings because thereis no camera lens affixed in front of the image sensor of the cornealtopography system. In some embodiments, software-controller digital zoomis still possible. In addition, in some embodiments, eliminating themobile communication device camera lens and utilizing the Kepleriantelescope system (which is in the corneal topography system) along withthe image sensor or camera sensor 410 of the corneal topography systemor housing also eliminates mobile communication device camera lenspositioning errors. In some embodiments, this leads to design where thefocus of the corneal topography system may be locked during themanufacturing without having to tweak or adjust each unit in apost-manufacture calibration.

In some embodiments, the projected Placido rings image (or otherilluminated pattern image) may be projected or reflected to the imagesensor or camera sensor 410 at a perfect focus. This configurationeliminates the need to use the mobile communication device camera and/orlens (and the resulting variations therein) to capture the reflectedPlacido rings image (or other illumination pattern image). In addition,because the corneal topography system or housing may comprise the imageor camera sensor, the image processing hardware and/or software and/orother corneal topography software may be moved into the cornealtopography system or housing 407. In some embodiments, the imageprocessing hardware and/or software and/or other corneal topographysoftware may be located on the topography-specific outboard or housing.

In some embodiments, the topography-specific PCB or outboard 412 mayfurther comprise computer-readable instructions stored on the one ormore memory devices that were described above (e.g., non-volatile memorydevices 416 and/or firmware 418). In some embodiments, thecomputer-readable instructions may be accessed and executed by one ormore processors 415 or 440 in order to control operation of othercomponents in the corneal topography system or housing 407. In someembodiments, the computer-readable instructions may be executed by oneor more processors or controllers 415 or 440 to control operation (e.g.,activation or deactivation) of 1) a Placido rings illumination subsystem(or other illumination pattern subsystem); 2) fixation LED assembly(e.g. a Green LED assembly) and generated fixation beam; 3) a LEDranging laser assembly (e.g., a Red LED assembly) and generated rangingbeam and/or 4) an infrared LED assembly and generated infrared lightbeam. In some embodiments, the Bluetooth communication transceiver (orPAN communication transceiver) from the previously disclosed cornealtopography system may be eliminated because the topography-specific PCBor outboard 412 may either communicate with the other components viawired connections (and/or wired communication protocols). In someembodiments, the components may be mounted or installed on thetopography-specific PCB or outboard 412 and thus may be communicatedwith over a wired communications interface or communication circuitry onthe topography-specific PCB or outboard 412.

In some embodiments, the corneal topography software may be stored inthe one or more memory devices 416 and 418 on the topography-specificPCB or outboard 412. In some embodiments, for example, topographylibrary software (e.g., computer-readable instructions) may be stored infirmware 418 that may be executable by the one or more processors 415 or440 that are installed on the topography-specific PCB (or outboard) orin other memory devices in the corneal topography housing. In someembodiments, the one or more processors may include an image processorthat is specifically designed to handle imaging processing functionsand/or analysis. In some embodiments, firmware 418 on thetopography-specific PCB (or outboard) 412 may store certain portions ofthe corneal topography software may include instructions that areexecutable by one or more processors or an image processor 440 to handledata intensive functionality (such as executing and initiating thecorneal topography system auto-capture functionality, the Placido ringsimage capture, the Placido rings edge detection and/or the cornealtopography power mapping), while allowing the one or more otherprocessors 415 to initiate and execute other functionality such asactivation of other components and/or transfer of information betweenthe corneal topography system or housing 407 and the custom-designed andfabricated mobile communication device 470. In some embodiments, the oneor more processors and/or related application software in the cornealtopography system or housing 407 may then only communicate or transferthe corneal topography related images and datafiles to thecustom-designed and fabricated mobile communication device for displayon the mobile communication device display. In some embodiments, thecustom-designed and fabricated mobile communication device may thenupload the necessary corneal topography images to a cloud-based server,without having to perform any image processing at the mobilecommunication device.

In this new configuration or embodiment (as illustrated in FIG. 4A), the“intelligence” of the mobile communication device-based cornealtopography system may be moved into a physical housing (or one or morephysical housings) that is outside of the custom-designed or fabricatedmobile communication device. Accordingly, a high-end mobilecommunication device with significantly processing power and/or an imageprocessing chipset is no longer needed to perform the corneal topographysoftware functionality. In some embodiments, a custom-designed andmanufactured mobile communication device may be utilized as the mobilecommunication device in the mobile communication device-based cornealtopography system. In some embodiments, an operating system may becreated and developed for the custom-designed and fabricated mobilecommunication device by the developer and creator of the cornealtopography system or housing (e.g., the corneal topography system),which is Intelligent Diagnostics, LLC. In some embodiments, thecustom-designed and fabricated mobile communication device 470 may onlybe required to have a monitor or display, a custom-designed and/ordeveloped (and thus proprietary and closed) operating system, one orprocessors, a wired communication interface or communication circuitry(e.g., USB or Ethernet communication circuitry), and/or a wirelesscommunication transceiver (e.g., a WiFi transceiver); a personal areanetwork transceiver—Bluetooth; and/or a cellular (3G, 4G, or 5G)transceiver, although many other components and/or software applicationsmay also be resident within the mobile communication device.

With this new system configuration, the corneal topography system maystill utilize one or more mirrors to fold an image beam path created bythe Keplerian telescope optical subassembly. However, it is notnecessary to utilize the mobile communication device camera that wasdiscussed in the prior ID patent applications. Thus, in the embodimentillustrated in FIG. 4A, the reflected image beam path may be decoupledfrom the mobile communication device camera and/or the entrance pupillocation of the associated lens. As discussed above, in FIG. 4A, theimage sensor or camera sensor 410 may integral and/or integrated intothe corneal topography system or housing 407 (and specifically may beintegrated as part of the topography-specific PCB or outboard 412). Insome embodiments of this new corneal topography system, the telescopeoptical system beam path may be short enough so that one mirror or twomirrors may be utilized for folding an image beam path. FIG. 4Billustrates use of one mirror for folding an image beam path in acorneal topography system according to some embodiments. FIG. 4Cillustrates use of two mirrors for folding an image beam path in acorneal topography system according to some embodiments. In someembodiments, as illustrated in FIG. 4B, a reflected illuminated patternimage (e.g., a reflected Placido rings image) may be transmitted orreflected to an image sensor 410 in the corneal topography system orhousing after being reflected by a mirror 480. In some embodiments, asillustrated in FIG. 4C, a reflected illuminated pattern image (e.g., areflected Placido rings image) may be transmitted or reflected to animage sensor 410 in the corneal topography system or housing after beingreflected by a first mirror 481 and/or a second mirror 482. In someembodiments, no mirrors may be necessary for folding an image beam path.Thus, in the last embodiment, mirrors utilized for folding an image beampath may be eliminated from the corneal topography optical system. Insome embodiments, mirrors and/or lenses may still be utilized tointroduce or direct the fixation beam and/or infrared (IR) light to thepatient's eye or cornea or for other features or functionality of thecorneal topography system.

In this new system configuration (FIG. 4A), the topography-specific PCBor outboard 412 may be placed in different locations relative to thecorneal topography system or housing 407 and the mobile communicationdevice to which this subsystem is attached. In some embodiments, theposition of the topography-specific outboard or PCB 412 may ‘float’ orbe moved relative to a position of the custom-designed and fabricatedmobile communication device 470. In some embodiments, the position ofthe topography-specific PCB 412 or outboard may be moved as long as theimage sensor or camera sensor 410 may be aligned to receive thereflected Placido rings image (or other illumination pattern image).Thus, in some embodiments, the position of the Placido rings assembly(or other pattern illumination assembly) may be exactly in a horizontalmidline of the custom-designed and fabricated mobile communicationdevice, even if the typical mobile communication device camera is off toone side or near to the top edge of the mobile communication device(e.g., as in the iPhone 7, 8 and 10-series phones among otherAndroid-based phones). This is because in the embodiment illustrated inFIG. 4A, the mobile communication device camera may not be utilized forimage capture of the reflected Placido rings image (or otherillumination pattern image). Thus, in some embodiments, the mobilecommunication device-based corneal topography system described in FIG.4A may be a bilaterally symmetric product as opposed to the slightlyasymmetric design that was disclosed in the previously submitted patentapplications.

In addition, the movement of the corneal topography application softwareto memory devices in the corneal topography system or housing 407 (andspecifically the topography-specific PCB or outboard 412) may provide anumber of advantages. One advantage is that the developer of the cornealtopography system or housing does not have to worry about mobilecommunication device camera drivers changing (and/or related mobilecommunication device operating system software changing). In otherwords, phone or mobile communication device manufacturers may push outupdates that contain drivers and/or other tweaks which may jeopardizethe operational stability of the corneal topography system. In this newconfiguration (FIG. 4A), the mobile communication device operatingsystem is also custom-designed and/or developed by the cornealtopography system creator or developer, so this situation should nolonger be an issue. In addition, the corneal topography system developermay also have control of the operating system of the custom-designedmobile communication device (and thus updates of the OS or drivers willnot be communicated to the mobile communication device unless thecorneal topography system or housing developer is aware of the impact tothe corneal topography system). In other words, the corneal topographysystem (and the software platform) may be controlled end-to-end by thedeveloper of the corneal topography system. In some embodiments, thecustom-designed and/or developed operating system may be Linux-basedrather than a phone-manufacturer branded flavor of Android. In someembodiments, a version of Linux (named Yocto—which is published byIntel) may be utilized as a base operating system to run thetopography-specific PCB (or outboard) 412 and other components in thecorneal topography system or housing and/or the custom-designed andfabricated mobile communication device.

FIG. 4A illustrates a block diagram of a new configuration of asmartphone corneal topography system according to some embodiments. Theblock diagram does not represent a shape of the corneal topographysystem or housing and instead is drawn as a simple rectangle. Inaddition, the optical path labeled in the corneal topography system orhousing 407 may not be indicative of the optical path (and/or componentsutilized therein) to transmit the reflected Placido rings image (orother illumination pattern image) to the image sensor or camera sensor410. In addition, no lenses or mirrors are shown in the block diagram ofthe corneal topography system or housing although the lenses or mirrorsmay be present in the corneal topography system or housing 407. In otherwords, this Figure (FIG. 4A) is not directed to illustrating ordescribing the optical path in the mobile communication device-basedcorneal topography system. Instead, FIG. 4A is illustrating a newconfiguration of the corneal topography system that brings the brainsand processing power into the corneal topography system or housing 407.

The mobile communication device-based corneal topography system 400comprises a corneal topography system or housing 407, a Placido ringsassembly or other pattern illumination assembly 410, a custom-designedand fabricated smartphone 470, and a slit-lamp microscope mountingassembly 475. In some embodiments, the Placido assembly (e.g., thePlacido rings assembly or other pattern illumination assembly) may bemounted on one side of a corneal topography system or housing 407 and acustom-designed mobile communication device 470 may be mounted orconnected to an opposite side of the corneal topography system orhousing 407. In some embodiments, the corneal topography system orhousing 407 may be connected or coupled to a slit lamp microscopemounting assembly 475.

In some embodiments, the corneal topography system or housing 407 maycomprise an image path 430, where the image path 430 may be a path thata reflected Placido rings image (or other illuminated pattern image)travels in order to enter an image sensor or camera sensor 410. In someembodiments, the corneal topography system or housing 407 may comprise atopography-specific PCB or outboard 412. In some embodiments, thetopography-specific PCB or outboard 412 may receive power from a powersource 411 in the corneal topography system or housing 407. In someembodiments, the power source 411 may be a rechargeable battery. In someembodiments, the power source 411 may be connected to an external poweroutlet or charging pad which provides power to the power source 411. Insome embodiments, computer-readable instructions 417 executable by oneor more processors 415 (or firmware 418 executable by one or moreprocessors 415) may activate an image sensor or a camera sensor 410 tocapture a reflected Placido rings image (or other illumination patternimage) transmitted via the image path 430. In some embodiments,computer-readable instructions 417 stored in one or more memory devices416 executable by one or more processors 415 (or the firmware 418executable by one or more processors 415 or controllers) may generateinstructions, commands or signals to perform operations in the cornealtopography system or housing 407. For simplicity, the specification mayrefer to computer-readable instructions executable by one or moreprocessors 415 from this point forward although the other embodimentsdescribed previously (e.g., firmware executable by one or moreprocessors or controllers) may also be utilized.

In some embodiments, the computer-readable instructions 417 executableby one or more processors 415 may perform auto-capture of the reflectedPlacido rings image (or other illumination pattern image). In someembodiments, the computer-readable instructions 417 executable by one ormore processors 415 may communicate the captured Placido rings image (orother illumination pattern image) to an image processor 440. In someembodiments, as described above, the image processor 440 may be aseparate processor or device from the one or more processors 415 inorder to offload intensive image processing operations from the one ormore processors 415. In some embodiments, the computer-readableinstructions 417 executable by one or more processors 415 may cause theimage processor 440 to perform additional corneal topography functionssuch as Placido rings edge detection and/or the corneal topography powermapping, as well as other corneal image manipulation or processing. Insome embodiments, firmware or computer-readable instructions located inan integrated circuit or a printed circuit board including the imageprocessor 440 may be executable by the image processor 440 to performcorneal topography functions such as the Placido rings imageauto-capture, Placido rings edge detection and/or corneal topographypower mapping. In other words, the image processor 440 may have its ownembedded software or firmware to perform corneal topography functions.

In some embodiments, the corneal topography related images and files(e.g., the reflected Placido rings image, the Placido rings edgedetection, data files corresponding to the Placido rings image and/orthe corneal topography power map) may be communicated to thecustom-designed and/or fabricated mobile communication device 470 fordisplay on the mobile communication device display and/or furthercommunication or transmission to additional computing devices. Thecorneal topography images and/or related files may be communicated tothe custom-designed and fabricated mobile communication device 470 via acommunication interface or communication circuitry 425 (e.g., USB-3interface), a cable 426 (e.g., a USB-3 Cable), and a mobilecommunication device communication interface or communication interfacecircuitry 427 (e.g., phone USB interface connector). In someembodiments, the topography-specific PCB or outboard 412 may comprisethe communication circuitry or communication interface 425. In someembodiments, the communication circuitry or communication interface 425may be a socket on the topography-specific PCB or outboard 412 and thecable 426 may be a ribbon cable. This eliminates the need for a wirelesscommunication transceiver (e.g., a Bluetooth transceiver) in the cornealtopography system or housing 407. This configuration also providesadditional security for the patient data (e.g., the patient cornealtopography images and related files) because the patient data may not behacked or stolen by obtaining patient data transmitted via a Bluetoothcommunications protocol. In other words, wired transmission of cornealtopography data is more secure than wireless transmission of cornealtopography data. In addition, commands, instructions, signals andmessages may be transmitted or communicated between the custom-designedand fabricated mobile communication device 470 and the cornealtopography system or housing 407 in order to control other components ofthe corneal topography system or housing 407.

In some embodiments, the computer-readable instructions 417 may beexecutable by one or more processors 415 of the topography-specific PCB412 to control operation of components in the corneal topography systemor housing 407 (or corneal topography optical bench). For example, insome embodiments, the one or more processors 415 of thetopography-specific PCB 412 may generate commands, instructions orsignals to cause the Placido rings (or other illumination pattern) toilluminate, the ranging beam to be generated and transmitted to thepatient's eye, the fixation beam to be generated and transmitted to thepatient's eye and/or the infrared beam to be generated and transmittedto the patient's eye. Similarly, in some embodiments, the one or moreprocessors 415 of the topography-specific PCB or outboard 412 maygenerate commands, instructions and/or signals to cause those beams tocease to be generated and/or the Placido rings to be turned off.

In some embodiments, for example, the computer-readable instructions 417may be executable by one or more processors 415 to generate a signal,command or instruction to a fixation beam assembly 452 to cause thefixation beam assembly 452 to generate a fixation beam (e.g., a greenfixation beam) which is transmitted to the patient's eye. Similarly,signals, commands and/or instructions may be generated and communicatedto turn off the fixation beam.

In some embodiments, for example, the computer-readable instructions 417executable by one or more processors 415 may generate a signal, commandor instruction to a ranging beam assembly 451 to cause the ranging beamassembly 451 to generate a ranging beam (e.g., a red ranging beam) whichis transmitted to the patient's eye. Similarly, signals, commands and/orinstructions may be generated and communicated to turn off the rangingbeam.

In some embodiments, for example, the computer-readable instructions 417executable by one or more processors 415 may generate a signal, commandor instruction to an infrared light assembly 453 to cause the infraredlight assembly 453 to generate an infrared light beam (e.g., an infraredlight beam) which is transmitted to the patient's eye. Similarly,signals, commands and/or instructions may be generated and communicatedto turn off the infrared light beam.

In some embodiments, for example, the computer-readable instructions 417executable by one or more processors 415 may generate a signal, commandor instruction to a Placido rings controller or circuitry 450 to causethe Placido rings controller 450 to generate signals, commands orinstructions to illuminate rings of the Placido rings assembly 410. Insome embodiments, the one or more processors may generate a signal,command or instruction directly to a Placido rings assembly 410 toilluminate the Placido rings. Similarly, signals, commands and/orinstructions may be generated and communicated to turn off theillumination of the Placido rings in the Placido rings assembly 410.

FIG. 5 illustrates an alternative embodiment utilizing a custom-designedand developed-mobile communication device according to some embodiments.In FIG. 5, the main difference with respect to FIG. 4 is that the camerasensor and potentially the corneal topography software, may be locatedor resident in the customized-designed and/or fabricated mobilecommunication device 570. Because the corneal topography system orhousing developer is also the developer of the custom-designed and/orfabricated mobile communication device, the developer can control alocation or position of the camera sensor and/or lenses in thecustom-designed and/or fabricated mobile communication device and thuswill not have the variations that are present in other phonemanufacturer's cameras and lenses (e.g., Apple, Samsung, Motorola,Google). Thus, the custom-designed mobile communication device cameramay be located at a horizontal center of the custom-designed mobilecommunication device and may receive the reflected Placido rings imagevia the image path 530. Because the corneal topography system developercontrols and/or has customized both pieces (e.g., the custom-designedand fabricated mobile communication device 570 and the cornealtopography system and housing 507), tight tolerances may be maintainedwith the optical components in both devices. In addition, the developerwill also control the custom-designed and developed mobile communicationdevice operating system and/or the corneal topography system operatingsystem, so unexpected driver updates (and potentially problematicupdates) for components of either system (e.g., the custom-designedmobile communication device and/or the corneal topography system orhousing) will not be an issue. In some embodiments, thetopography-specific PCB or outboard that was disclosed in FIG. 4A may beeliminated in FIG. 5. In some embodiments, the custom-designed and/orfabricated mobile communication device 570 may communicate commands,signals and/or instructions with the corneal topography system orhousing 507 via a wired communication interface or communicationcircuitry 526 (e.g., a USB-3 interface) utilizing a cable 527 and thewired communication interface or communication circuitry 525 in thecorneal topography system or housing 507. Alternatively, thecustom-designed and/or fabricated mobile communication device 570 maycommunicate commands, signals and/or instructions with the cornealtopography system or housing 507 utilizing a wireless communicationinterface 526 such as Bluetooth or Wi-Fi without the need of a physicalcable. In some embodiments, the custom-designed mobile communicationdevice communication interface or communication circuitry (whether wiredor wireless) may control operations of components in the cornealtopography system or housing 507, such as the fixation light source 552,the infrared light source 553, the ranging light source 551 and/or thePlacido rings illumination assembly (or other pattern illuminationsystem) 510. In some embodiments, computer-readable instructions 517stored in one or more memory devices 516 and executable by the one ormore processors 515 in the custom-designed mobile communication device570 may perform image processing of the reflected Placido rings image orother illuminated pattern image (the operations or which were describedpreviously). In other words, in FIG. 5, the corneal topographyapplication software would be stored and executed by one or moreprocessors on the custom-designed mobile communication device.

FIG. 6A illustrates a side view of components of a mobile communicationdevice-based corneal topography system according to some embodiments. Insome embodiments, the mobile communication device-based cornealtopography system 600 may comprise a mobile communication device 605; atopography processor 615 and/or a topography printed circuit board 620;an image sensor 626 and/or an image sensor printed circuit board 626;one or more lens assemblies (e.g., a first lens assembly 630, a secondlens assembly 631, and/or a third lens assembly 632), a mirror 610,and/or an optical tube that includes an illumination pattern source 640.In some embodiments, the mobile communication device-based cornealtopography system 600 may further comprise a fixation beam source 635and/or a fixation mirror 636. In some embodiments, the mobilecommunication device-based corneal topography system 600 may furthercomprise a ranging beam source 710 and/or one or more proximity sensors720 (both illustrated in FIG. 7A). In some embodiments, the mobilecommunication device 605 may comprise a mobile communication devicedisplay 606.

There is a significant advantage to moving to a mobile-communicationdevice-based corneal topography system having an image sensor and/ortopography processing hardware and/or software outside of the mobilecommunication device (which may be referred to as outboard). All mobilecommunication device (e.g., smartphone) cameras or sensors have theirown integrated lens systems with auto-focus and zoom. These features arenot needed in the corneal topography system and if the mobilecommunication device camera was utilized as the sensor in the cornealtopography system, these features would need to be disabled and/or awork around would need to be developed. In addition, all mobilecommunication device cameras incorporate infrared and/or far red filtersto eliminate “red eye” in photos. The corneal topography systemdescribed and claimed herein desired to eliminate this filter (infraredand/or far red) and instead utilize the red light and infrared spectrumfor pupil edge detection, and potentially autorefraction. In addition,even in high end name-brand mobile communication devices such as AppleiPhone and Android phones, there are very tiny differences in spacing ofthe mobile communication device lens(es) from the image sensor orcamera. For corneal topography features, if the mobile communicationdevice camera is utilized, these very tiny differences would need to bemeasured, recorded and/or factored in calibration for each and everyinstrument (e.g., mobile communication device-based corneal topographysystem). Having to measure, record and factor these very tinydifferences for each mobile communication device would be clunky,cumbersome, undersireable and costly in a production context. Thus, byutilizing an image sensor outside the mobile communication device, theimage sensor may be bonded to the optical bench (which includes all ofthe lensing elements (e.g., lens)) so that the spacing for eachinstrument is uniform, reproducible and/or consistent. In addition, bynot having to guide the reflected image of the illumination patternthrough a mobile communication device lens system, the configurationsdescribed herein is optimized so that a design of the imaging system forimaging the reflected illumination pattern of the cornea to thededicated image sensor.

In some embodiments, the image sensor 625 may communicate with thetopography processor 615) and/or other components on a topography PCB620 via an interface, such as a MIPI interface. In some embodiments, thecorneal topography system may comprise a battery or power source (e.g.,such as a lithium ion battery) that is included in a housing. In someembodiments, the topography processor may be configured withinstructions to communicate with other components or assemblies within ahousing or the mobile communication device-based corneal topographysystem 600 such as one or more thermal or temperature sensors (notshown), a fixation beam source 635, the illumination source (orillumination pattern source) 640, the ranging beam source 710, and/or aninfrared light source (shown in FIG. 3). In some embodiments, theillumination pattern source 640 may comprise two parts. In someembodiments, the illumination system may be referred to as anillumination pattern source. In some embodiments, the illuminationsystem 641 may generate an illumination pattern that is reflected of acornea of a subject or patient. In some embodiments, an imaging systemmay be coupled to the illumination system and coupled to an imagesensor. In some embodiments, the imaging system may direct the reflectedillumination pattern to the image sensor. In some embodiments, the imagesensor 625 may capture an image of the reflected illumination pattern.An important advantage of the embodiments described in FIGS. 6A, 6B, 7Aand 7B is that the image sensor 625 may be located in an optical housingand is separate from an image sensor or camera in the mobilecommunication device 605. As described previously, including the imagesensor in a housing with the imaging system allows a fixed alignment ofthe image sensor 625 and the imaging system. In addition, it eliminatesthe mobile communication device-based corneal topography system havingto identify and/or address the different characteristics andspecifications of the image sensors in the mobile communication device,as well as potential different mobile communication device image sensorlocations.

In some embodiments, the mobile communication device-based cornealtopography system may further comprise an interface. In someembodiments, the interface may be the Mobile Industry ProcessorInterface (or MIPI interface) (not shown). In some embodiments, the MIPIinterface may be coupled to the image sensor 625 and/or the topographyprocessor 615. In some embodiments, the image sensor 625 may beconfigured with instructions to communicate, via the MIPI interface, thecaptured images of the reflected illumination pattern to the topographyprocessor 615. In some embodiments, the topography processor 615 may beconfigured with instructions to communicate the captured image of thereflected illumination pattern to the mobile communication forpresentation on the display of the mobile communication device 605 toallow for viewing by the Examiner. In some embodiments, thecommunication of the reflected illumination pattern image to the mobilecommunication device may occur in real time. In some embodiments, thetopography processor 615 may be configured with instructions to controloperation of the image sensor (e.g., to specify parameters ormeasurements of the image captured by the image sensor 625). In someembodiments, the topography processor 605 may communicate commands orinstructions to the image sensor 625 to control a size, a resolutionand/or a frequency of when an image is refreshed or recaptured (whichmay be referred to as a frame rate). In some embodiments, the topographyprocessor may communicate instructions to the image sensor 625 todown-size an image. For example, for the auto-capture process describedabove and below, a high resolution (e.g., 3K×3K) may be utilized for theimage being evaluated in the auto-capture process whereas for atopography process (e.g., rings analysis process that is describedbelow), a smaller resolution (e.g., 1×1K) of the captured image of thereflected illumination pattern may be utilized. During the auto-captureprocess, the topography processor 615 may be configured withinstructions to enable or set different regions of interest in thereflected image of the fixation beam and/or the ranging beam. In thisembodiment, then the topography processor 615 may only be evaluating acenter area of the reflected image of the fixation beam and/or theranging beam to find and determine overlap of the fixation beams and theranging beam. In this embodiment, this may allow the corneal topographysystem described herein to utilize a higher frame rate to achieveauto-capture and/or also to utilize a higher resolution image at thatframe rate.

In some embodiments, a topography processor 615 may be configured withinstructions to process the image of the reflected illumination patternto generate topography map images and/or one or more topography datafiles. In some embodiments, the topography data files may include 1)ring edge location measurements, 2) calibration data, 3) patientidentifier data and/or 4) x, y and/or z-axis offset data. In someembodiments, the topography processor 615 may be configured withinstructions to communicate the generated topography map images and theone or more data files to the mobile communication device 605. In someembodiments, a processor on the mobile communication device 605 may beconfigured with instructions to present the generated one or moretopography map images on a display of the mobile communication device.

In some embodiments, the mobile communication device-based cornealtopography system may utilize an auto-capture process to verify thataccurate positioning in the x, y and z-axis of a cornea (of the subject)is present as the reflected illumination pattern is captured. In someembodiments, the pattern illumination source or component 640 may not beinitially illuminated. In some embodiments, the pattern illuminationsource or component 640 may be illuminated. In some embodiments, afixation beam source 635 may generate a fixation beam which may travelon a fixation path which forms fixation axis (which has two portions 655and 656). In some embodiments, the fixation beam defines a fixationtarget visible to the eye of the subject, the fixation target beamcomprising a first wavelength of light. In some embodiments, a rangingbeam source 710 may generate a ranging beam 715 and direct the rangingbeam to the cornea of the subject. In some embodiments, the ranging beam715 may also be referred to an alignment beam and the ranging beamsource 710 may be referred to as an alignment beam source. In someembodiments, the ranging beam 715 may comprise a second wavelength oflight that is different from a first wavelength of light. In someembodiments, the ranging beam 715 may travel along a path which may bereferred to as a ranging axis. In these embodiments, the image sensor625 may capture a reflected image of a ranging beam and a fixation beamon the cornea of the subject. In some embodiments, as shown an anglebetween the fixation axis (beam) and the imaging axis (beam) isillustrated by reference number 716.

In these embodiments, the image sensor 625 may be configured withinstructions to communicate the reflected image of the ranging beam andthe fixation beam to the topography processor 615 via the interface. Inthese embodiments, the topography processor 615 may communicate thereflected image of the alignment beam and the fixation beam to themobile communication device 605 to display on the mobile communicationdevice display 616 and to allow the examiner to move the cornealtopography system. In some embodiments, multiple frames of the reflectedimage of the fixation beam and the ranging beam may be communicated fromthe image sensor 625 to the topography processor 615. In someembodiments, the one or more frames of the reflected image of thefixation beam and the ranging beam may be communicated from thetopography processor to the mobile communication device 605. In someembodiments, the one or more frames of the reflected image of thefixation beam and the ranging beam may include a mark or cross hair(e.g., a fiducial mark) which may be utilized to identify a center of anoverlap of the fixation beam and the ranging beam by the operator (e.g.,the examiner) of the mobile communication device-based cornealtopography system. In other words, the mark or cross-hair (e.g., yellowcross-hairs) facilitate proper alignment, by providing visual cues tothe person performing the topography exam. In some embodiments, aprocess of centering the ranging and fixation beams may require operatorguidance of steering the mobile communication device-based cornealtopography system when mounted on the slit lamp microscope so as toachieve an optical position of the fixation and ranging beam within theyellow cross-hairs.

In these embodiments, the topography processor 615 may be configuredwith instructions to determine if the ranging beam and the fixation beamare overlapping. In these embodiments, for example, the topographyprocessor 615 may be configured with instructions to determine the beamsare overlapping by tracking the first wavelength of light (e.g., thefixation beam) and the second wavelength of light (e.g., the rangingbeam) with spectral analysis. In some embodiments, the topographyprocessor 615 may also be configured with instructions to verify that anoverlap of fixation beam and the ranging beam are in alignment with afiducial mark or cross-hairs in the reflected image of the fixation beamand the ranging beam (the cross-hairs may be yellow cross-hairs in orderto stand out or be distinct from a red ranging beam and green fixationbeam). In some embodiments, the operator or user may move the fiducialmark or cross-hairs by moving the mobile communication device-basedcorneal topography system 600 utilizing the joystick or similar deviceon the slit lamp microscope (to which the system 600 is mounted). If thetopography processor 615 determines that these conditions have been met(e.g., beams overlapping and aligned with fiducial mark or cross-hairs),the topography processor 615 may be configured with instructions to turnoff or deactivate the fixation beam source 635 and/or the ranging beamsource 710. In other words, the topography processor 615 may sendshutdown or deactivation commands or instructions to the fixation beamsource 635 and/or the ranging beam source 710.

In some embodiments, once it is determined that the fixation beam andthe alignment beam are overlapping each other, the topography processor615 may be configured with instructions to instruct, command or signalthe pattern illumination component or source 640 to turn on and/orilluminate in order to project the illumination pattern onto the corneaof the subject. In some embodiments, the pattern illumination componentor source 640 may already be illuminated and thus be projecting anillumination pattern on a cornea of the subject. In these embodiments,the topography processor 615 may be configured with instructions tocommand, instruct and/or signal the image sensor 625 to capture areflected illumination pattern image. In these embodiments, the imagesensor 625 may be configured with instructions to automatically capturethe reflected illumination pattern image and to communicate the capturedreflected illumination pattern image to the topography processor 615. Inother words, no human intervention may be required in performing thesesteps. The auto-capture process described herein is an advantage overprior art systems where multiple tests have to be performed in order toan image of acceptable quality. This auto-capture process helps reducehuman error in capturing images of the reflected illumination pattern atthe correct corneal vertex. This auto-capture process will speed upexaminations of subjects and improve the quality and accuracy of thecaptured images, as well as the topography map images and the one ormore topography data files generated therefrom.

In these embodiments, the image sensor 625 may be configured withinstructions to communicate, via the interface, the captured reflectedillumination pattern image to the topography processor 615 fortopography processing. In these embodiments, the topography processor615 on a topography PCB 620 may be configured with instructions toperform topography processing and to generate one or more topography mapimages and one or more topography data files. In some embodiments, thetopography processor 615 may be configured with instructions tocommunicate the generated one or more topography map images and the oneor more topography data files to the mobile communication device 605. Insome embodiments, the topography processor may also communicate thecaptured image of the reflected illumination pattern (or some derivativethereof) to the mobile communication device 605. In some embodiments,the processor of the mobile communication device 605 may be configuredwith instructions to present the one or more topography map images onthe display 606 (either by themselves or with the reflected illuminationpattern image (e.g., the captured reflected illumination patternimage)). In some embodiments, the processor of the mobile communicationdevice 605 may be configured with instructions to communicate thereflected illumination pattern image (or a derivative thereof) and/orthe one or more topography data files to a cloud-based server and/orremote computing device for storage and/or analysis.

In some embodiments, the communication of 1) reflected illuminationpattern images; 2) one or more topography map images; and 3) one or moretopography data files to the mobile communication device may occurutilizing a wired communication interface. In some embodiments, thewired communication interface may operate according to the USB-2 and/orthe USB-3 communication protocol (although other communications protocolmay be utilized). In some embodiments, the wired communication interfacemay be a USB-2 and/or USB-3 cable. The utilization of the wiredcommunication interface provides protection from outside individualsbeing able to access and/or hack the reflected illumination patternimages, the topography map images and/or the one or more topography datafiles as they are being transferred to the mobile communication device.This protection is a significant advantage over other systems as itprovides protection for subject's personal health-related data. In someembodiments, the mobile communication device 605 may utilize one or morewireless communication transceivers to communicate the reflectedillumination pattern image (or derivative thereof) and the one or moretopography data files to a cloud-based server and/or remote computingdevice. In some embodiments, the one or more wireless communicationtransceivers may be transceivers operating according to any one of anumber of 802.11 protocols, WiFi transceivers and/or wireless LANprotocols. In some embodiments, the one or more wireless communicationtransceivers may be cellular transceivers which operate according to the3G, 4G and/or 5G communication transceivers. In some embodiments, theone or more wireless communication transceivers may be personal areanetwork transceivers (e.g., Zigbee, Bluetooth, and/or Bluetooth LowEnergy transceivers, or potentially NFC transceviers).

In some embodiments, the topography processor 615 on a topography PCB620 may be configured with instructions to perform multiple steps aspart of the topography processing of the captured image of the reflectedillumination pattern. Below is a representative example of differentsteps in topography processing. However, slight variations to the stepsor process described below (for topography processing) may be utilizedwith the claimed subject matter. In an embodiment, for example, thetopography processor 615 may be configured with instructions to findand/or locate centroids of central rings of the reflected illuminationpattern and then utilize the centroids data to determine a position of avertex normal for the cornea being analyzed. In this embodiment, forexample, the topography processor 615 may be configured withinstructions to calculate and/or determine other data (e.g., such asx-y-z offset data from a perfect position). In this embodiment, thex-y-z offset data may be utilized as an indicator of test accuracyand/or reliability. In other words, the x-y-z offset data may be thoughtof as any decentration, pitch or yaw of the corneal apex from theexpected position.

In this embodiment, for example, the topography processor 615 may beconfigured with instructions to 1) find and/or determine ring edgelocations and/or 2) represent these ring edge location in polarcoordinates, through 360 degrees of arc in 1-degree increments for allrings of the captured image of the reflected illumination pattern. Inthis embodiment, for example, if there are 28 rings in the image of thereflected illumination pattern, that means there are 56 ring edges.

In this embodiment, for example, a topography processor 615 may beconfigured with instructions to create a topography data file or one ormore topography data files. In some embodiments, the topography datafile may comprise data representative of ring edge locations (e.g., thepolar coordinates described above), calibration reference data, patientidentifier data and/or right eye/left eye data. In some embodiments, thetopography data file may further comprise x-y-z offset data and/orvertex normal data. In some embodiments, the topography data file may bemore than a single file and may be referred to as one or more topographydata files.

In this embodiment, for example, the topography processor 615 may beconfigured with instructions to 1) analyze the topography data file (orthe one or more topography data files) and 2) generate topography powermaps (or topography map images) along with statistical data andderivative analyses data (which is based upon the statistical data). Insome embodiments, the one or more topography data files described abovemay further comprise the statistical data and/or the derivative analysisdata.

In some embodiments, other components and/or assemblies (e.g., memorydevices (volatile and/or non-volatile), controllers, flash memories,etc.) on a topography PCB 620 may assist the topography processor 615 inperforming the below listed operations. Although the topography PCB 620is described as a single printed circuit board, multiple printed circuitboards and/or chipsets may be utilized to perform the functionsidentified as being performed by the topography PCB 620. Although thetopography processor is described as a single processor, multipleprocessors and/or chipsets may be utilized to perform the functionsidentifier as being performed by the topography processor 615. Inaddition, in some embodiments, the topography PCB 620 may also compriseone or more interfaces to communicate with other components orassemblies within the mobile communication device-based cornealtopography system.

FIG. 6B illustrates axis' and/or planes in a mobile communicationdevice-based corneal topography system according to some embodiments. Insome embodiments, the mobile communication device-based cornealtopography system 600 may comprise an imaging system. In someembodiments, the imaging system may comprise one or more lens assemblies(e.g., lens assemblies 630, 631 and 632), the optical tube including theillumination pattern source 640 (which may be a Placido ringsillumination source), the mirror 610 (or beam mirror) and the imagesensor 625. In some embodiments, the illumination pattern source 640 maygenerate an illumination pattern and cause an illumination pattern to bereflected off a subject's cornea. In some embodiments, the reflectedillumination pattern may be reflected off the mirror 610 through one ormore lens assemblies (e.g., lens assemblies 630, 631 and 632) to theimage sensor 625. In some embodiments, the path travelled by thereflected illumination pattern of the subject's cornea may be referredto as the imaging axis or imaging path. In some embodiments, the imagingaxis may also be referred to as the optical axis. In some embodiments, afirst portion of the imaging axis 660 may extend from the subject'scornea to the mirror 610. In some embodiments, a second portion of theimaging axis 661 may extend from the mirror 610 to the imaging sensor625. In some embodiments, the one or more lens assemblies (e.g., lensassemblies 630, 631 and 632) may be positioned along the second portionof the imaging axis 661 or the optical axis to image the reflectedillumination pattern so as to fit a size of the image sensor 625. Insome embodiments, the one or more lens assemblies may be positionedalong the second portion of the imaging axis 661 or the optical axis toimage the reflected illumination pattern at a magnification so as to fita size of the image sensor 625, and wherein the magnification is between0.25 to 0.75, optionally 0.35 to 0.65, or optionally 0.45 to 0.55. Insome embodiments, the one or more lens assemblies may be positionedalong the second portion of the imaging axis 661 to image the reflectedillumination pattern at a magnification so as to fit a size of the imagesensor, wherein the magnification may be between 0.75 to 1 oralternatively greater than 1. With the single mirror configurationdisclosed in FIG. 6A and FIG. 6B, the corneal topography system may foldthe imaging beam path (or imaging axis), which shortens an otherwiseuncomfortably long image path or imaging axis so that it can be utilizedin the slit-lamp mounted context. This preserves the relative positionthat is normally occupied by the examiner and the patient on either sideof the slit lamp during an examination.

In some embodiments, the optical path extending from the subject'scornea to mirror 610 may be referred to as a first portion of theoptical axis. In some embodiments, the optical path extending from themirror 610 through the one or more lens assemblies and to the imagesensor 625 may be referred to as a second portion of the optical axis.In some embodiments, the optical axis may be aligned with the imagingaxis.

In some embodiments, the topography processor 615 may be supported by atopography printed circuit board (PCB) 620. In some embodiments, thetopography printed circuit board 620 may be inclined at an angle withrespect to vertical. In some embodiments, the topography PCB may extendalong a topography PCB plane 651. In some embodiments, the mobilecommunication device (MCD) 605 may be inclined at an angle with respectto a vertical axis. In some embodiments, the mobile communication device605 may comprise an MCD printed circuit board supporting an MCDprocessor. In some embodiments, the mobile communication device mayextend along an MCD plane 650. In some embodiments, the display 606 ofthe mobile communication device 605 may be inclined with respect to avertical axis. In some embodiments, the display 606 may extend along adisplay plane 652. In some embodiments, the image sensor 625 may besupported by an image sensor PCB 626. In some embodiments, the imagesensor PCB 626 may extend along an image sensor plane 653.

In some embodiments, the mobile communication device 605 may furthercomprise one or more memory devices, one or more wireless communicationtransceivers, one or more near-field communication (NFC) transceivers,one or more Global Positioning System (GPS) transceiver or receivers,and/or one or serial communication transceivers and/or interfaces. Insome embodiments, a number of the above-mentioned components may besupported, coupled and/or attached to an MCD printed circuit board.

FIG. 7A illustrates a top view of components and assemblies of a mobilecommunication device-based corneal topography system according to someembodiments. FIG. 7B illustrates a front view of components andassemblies of a mobile communication device-based corneal topographysystem according to some embodiments. In some embodiments, the imagingsystem of the mobile communication device-based corneal topographysystem may include a fixation beam source 635 to generate a fixationbeam, the fixation beam defining a fixation target visible to the eye ofthe subject. In some embodiments, the fixation target beam may comprisea first wavelength of light. In some embodiments, a ranging beam source710 may generate a ranging beam 715, the ranging beam 715 comprising asecond wavelength of light and the second wavelength of light may bedifferent from the first wavelength of light. In some embodiments, theranging beam 715 may travel along a ranging axis. In some embodiments,an angle between the fixation beam and the ranging beam 716 may beillustrated as 716 in FIG. 7A.

In some embodiments, the image sensor 625 may be configured to image areflection of the fixation beam and the ranging beam from the cornea ofthe subject and communicate the image of the reflection of the fixationbeam and the ranging beam to the topography PCB 620 (via an interface).In some embodiments, the topography processor 615 on a topography PCB620 may be configured with instructions to determine when the fixationbeam and the ranging beam are overlapping (e.g., as discussed in detailabove and as illustrated in FIGS. 1 and 2). In some embodiments, whenthe fixation beam and the ranging beam are found to be overlapping, thetopography processor 615 may be configured with instructions to turn offthe fixation beam source and the ranging beam source. The fixation beamsource and the ranging beam source may be turned off or deactivated toeliminate those beams from the reflected illumination pattern. In someembodiments, the topography processor 615 may be configured withinstructions to instruct, command or cause the image sensor 625 toautomatically capture an image of the reflected illumination pattern. Asdiscussed previously, the overlapping of the fixation beam and alignmentbeam allows the image sensor 625 to automatically capture the reflectedillumination pattern at the correct corneal vertex.

In some embodiments, the ranging beam 715 may travel along a rangingaxis and the fixation beam may travel along a fixation axis 656 (e.g., asecond portion of the fixation axis 656) and there may be anintersection (as illustrated by reference number 717 in FIG. 7A). Insome embodiments, the ranging axis may be at an angle 716 with respectto the fixation axis 656 within a range of 25 to 65 degrees, optionally40 to 60 degrees and optionally 45 degrees. In some embodiments, becausean intersection may involve two beams (e.g., the fixation beam and theranging beam), the intersection 717 may not be a point but more a spotor area or intersection as shown previously in FIGS. 1A, 1B and 2.

In some embodiments, the image sensor 625 may comprise an array ofpixels, the array comprising a first plurality of pixels more sensitiveto the first wavelength than the second wavelength and a secondplurality of pixels more sensitive to the second wavelength than thesecond wavelength. In some embodiments, the first wavelength maycomprise a first color and the second wavelength may comprise a secondcolor different from the first color. In some embodiments, the MCDprocessor may be configured with instructions to display a portion ofthe reflected fixation beam and the reflected ranging beam on a display606 of the mobile communication device 605. In some embodiments, the MDCprocessor may be configured with instructions to display where the firstbeam overlaps with the second beam with a different color than the firstwavelength and the second wavelength. In some embodiments, the rangingbeam may be configured to overlap with the fixation beam at a vertex ofthe cornea.

In some embodiments, the fixation beam may comprise substantiallycollimated light prior to reflection off the subject's cornea. In someembodiments, the image of the fixation beam from an anterior surface ofcornea may comprise a maximum size across within a range from about 10um to about 1 mm. In some embodiments, the fixation beam may becollimated to within about 5 degrees. In some embodiments, the rangingbeam may be focused to the waist at a full cone angle within a rangefrom about 1 degree to about 45 degrees. In some embodiments, theranging beam 715 may comprise an image of scattered light from thecornea when a tear film covers the cornea and optionally wherein thescattered light comprises light scattered from Bowman's membrane orcorneal stroma of the eye beneath the tear film.

In some embodiments, the mobile communication device-based cornealtopography system 600 may further comprise a fixation beam source 635and a fixation mirror 636. In some embodiments, the fixation beam source635 may generate a fixation beam or fixation light beam which may travelalong a fixation path or fixation axis. In some embodiments, a fixationaxis or fixation path may include a first portion 655 and a secondportion 656, although in other embodiments the fixation path or fixationaxis may include one portion or more than two portions. In someembodiments, as illustrated in FIG. 6B, a first portion 655 of afixation axis or path may be from the fixation beam source 635 to thefixation mirror 636. In some embodiments, as illustrated in FIG. 6B, asecond portion 656 of the fixation axis or path may be from the fixationmirror 636 to the cornea of the subject or patient. In some embodiments,as illustrated in FIG. 6B, the second portion of the fixation axis 656may be aligned and/or coaxial with a first portion of the imaging axis660.

In some embodiments, the fixation beam source 635 may transmit afixation beam to the fixation mirror 636. In some embodiments, thefixation beam is reflected from the fixation mirror 636 to a mirror 610and onto to the cornea of the subject being examined. In someembodiments, the mirror 610 may be a dichroic mirror that transmits thefixation beam along a second portion 656 of the fixation axis to thecornea of the subject. In some embodiments, the dichroic mirror may alsotransmit (and not reflect) the infrared beam utilized in pupil edgedetection to the cornea (as discussed with respect to FIG. 3). In someembodiments, the dichroic mirror may reflect the reflected illuminationpattern or the reflected image of the alignment beam and/or the fixationbeam to the image sensor 625. In other words, the mirror 610 may be apartial transmittance, partial reflectance mirror where certainwavelengths are transmitted through the mirror, whereas otherwavelengths are reflected off the mirror 610. In some embodiments, themirror 610 may be positioned or have an angle of inclination ofapproximately 135 degrees with respect to the second portion of thefixation axis 656 (when being viewed from the fixation mirror 636).Alternatively, in some embodiments, the mirror 610 may have an angle ofinclination with respect to the second portion 656 of the fixation axisin a range of 95 to 175 degrees, optionally 110 to 160 degrees, oroptionally 125 to 145 degrees.

In some embodiments, as is illustrated in FIG. 7B, the mobilecommunication device-based corneal topography system 600 comprises anoptical tube or illumination source component 640 and a ranging beamsource 710. In some embodiments, the ranging beam source 710 may becoupled or connected to an outside surface of the optical tube orillumination source component 640. In some embodiments, the optical tubeor illumination source component 640 may include an opening, where theopening extends from the outside surface of the optical tube 640 to theinside surface of the optical tube to define an aperture therebetween.In these embodiments, the ranging beam source 710 may transmit theranging beam 715 through the aperture to the cornea of the subject. Insome embodiments, the ranging beam source 710 may be coupled to theoutside surface of the optical tube 640 at a position between 1 o'clockand 5 o'clock with respect to vertical, optionally between 2 o'clock and4 o'clock, or optionally at 3 o'clock with respect to vertical.

In some embodiments, a housing (which may be referred to as an opticalhousing) may enclose the illumination system 641, the imaging system(including the image sensor 625) and the topography processor 615(and/or the topography printed circuit board (PCB) 620). In otherembodiments, the housing may also enclose the mobile communicationdevice 605. In other embodiments, the housing may partially enclose theillumination system 641, the imaging system (including the image sensor625) or the topography processor 615 (and/or the topography printedcircuit board (PCB) 620). In these embodiments, the housing may furtherpartially enclose the mobile communication device 620. In other words,the mobile communication device-based corneal topography system 600described herein may include a housing that has different combinationsof components and/or assemblies that are enclosed and/or covered by thehousing.

FIG. 8 illustrates a side view of a housing enclosing portions of themobile communication device-based corneal topography system 600according to embodiments. In some embodiments, as illustrated by FIG. 8,the housing 805 may enclose the illumination pattern source, the imagingsystem, e.g., mirror 610, fixation mirror 636, fixation beam source 635,lens assemblies (e.g., 630, 631, 632), the image sensor 626 and theimage sensor PCB 626, the topography processor 615 and the topographyPCB 620. In some embodiments, the housing 805 is coupled to a post 810or assembly to insert into the slit-lamp microscope stand in order tomount the mobile communication device-based corneal topography system600 to the slit-lamp microscope. In the embodiment illustrated in FIG.8, the mobile communication device 605 may be attached or mounted to aside of the housing 805 or may be partially enclosed by the housing 805.FIG. 8 is an illustrative embodiment of the housing of the mobilecommunication device-based corneal topography system 600 and many otherconfigurations may be utilized with the subject matter described herein.In some embodiments, certain assemblies or components or devices orboards may be partially enclosed by a housing, and in other embodiments,certain assemblies, components, devices or boards may be attached to thehousing 805.

In some embodiments, the post 810 is coupled to a support 811, which isconfigured to support the housing 805 and internal components within thehousing. In some embodiments, the housing 805 is configured to beremoved while post 810 and support 811 support the internal components,in order to allow alignment and servicing of the topography system. Thesupport 811 may comprise any suitable structures to support the internalcomponents. In some embodiments, the support is coupled to and supportsthe imaging system, e.g., mirror 610, fixation mirror 636, fixation beamsource 635, lens assemblies (e.g., 630, 631, 632), the image sensor 626and the image sensor PCB 626, the topography processor 615 and thetopography PCB 620. The support may comprise one or more of extensions,rails, plates, optical mounts, rails or other structures to support themobile communication device-based corneal topography system 600 withpost 810 in order to allow the topography system to couple to a slitlamp base and pivot as described herein.

In the Figures presented herein, the components and/or assemblies of themobile communication device-based corneal topography system areconfigured in specific alignments in order to efficiently utilize spacein the housing, in accordance with some embodiments. Other embodiments,may have different alignments and/or spacing the components assembliesand/or devices of the mobile communication device-based cornealtopography system as described herein.

Referring again to FIGS. 6A and 6B, in some embodiments, an angle ofinclination of a display plane 652 may be within 20 degrees of an angleof inclination of the topography PCB plane 651, optionally within 10degrees of an angle of inclination of the topography PCB plane 651, oroptionally parallel with an angle of inclination of the topography PCBplane 651. In some embodiments, an angle of inclination of a mobilecommunication device plane (MCD plane) 650 may be within 30 degrees ofan angle of inclination of the topography PCB plane 651, optionallywithin 10 degrees of an angle of inclination of the topography PCB plane651 or optionally parallel with an angle of inclination of thetopography PCB plane 651. In some embodiments, an angle of inclinationof the image sensor plane 653 with respect to the topography PCB plane651 may be within a range from 45 degrees to 135 degrees, optionallyfrom 75 degrees to 105 degrees, optionally from 85 degrees to 95degrees, optionally at an oblique angle, or optionally perpendicular. Insome embodiments, an angle of inclination of the image sensor plane 653with respect to the display plane 652 may be within a range from 45degrees to 135 degrees, optionally from 75 degrees to 105 degrees,optionally from 85 degrees to 95 degrees, optionally at an obliqueangle, or optionally perpendicular with respect to the topography PCBplane 651.

In some embodiments, the first portion of an imaging axis 661 may bealigned with an axis extending along the optical tube including theillumination pattern source 640. In some embodiments, the first portionof the imaging axis 661 may be inclined at an angle with respect to thesecond portion of the imaging axis 662, the angle within a range from 60to 120 degrees, optionally within a range from 80 to 100, optionally anoblique angle or optionally a perpendicular angle. In some embodiments,a second portion of the fixation axis 656 may be within a range from 25to 65 degrees with respect to a first portion of the fixation axis 655,optionally 35 to 55 degrees, or optionally 45 degrees. In someembodiments, the second portion of the fixation axis 656 may be within arange from 45 degrees to 135 degrees with respect to a second portion ofthe imaging axis 661, optionally 75 degrees to 105 degrees, optionally85 degrees to 95 degrees, optionally at an oblique angle, or optionallya perpendicular angle. In some embodiments, the second portion of thefixation axis 656 may be aligned with a first portion of the imagingaxis 660.

In some embodiments, a fixation beam may extend along a fixation beamoptical path or fixation axis. In some embodiments, a portion of anoptical path of the imaging system may overlap with the fixation beamaxis or fixation beam optical path. In some embodiments, the MCD planeand the topography PCB plane may be inclined with respect to the portionof the fixation beam optical path or fixation axis. Although theillumination pattern illustrated in many diagrams is a Placido rings,the subject matter described herein may be utilized with otherillumination patterns.

In some embodiments, the imaging system of mobile communicationdevice-based corneal topography system may include an opticalconfiguration to adjust the image of the reflected illumination patternbeing evaluated and also to decrease an optical path length between thecornea of the subject and the image sensor 625. In some embodiments, asurface of the mobile communication device 605 may be tilted withrespect to a vertical axis to provide enhanced viewing of the reflectedillumination pattern image by the examiner. In some embodiments, theillumination system source or component may be tilted upward withrespect to a horizontal axis to facilitate alignment with an eye of asubject being examined. In some embodiments, the illumination system640, the housing 680 and the mobile communication device 605 may beadjustable on a base to maintain a horizontal plane of alignment betweena subject and an examiner during operation of the corneal topographysystem. In some embodiments, the mobile communication device-basedcorneal topography system 600 may further comprise one or more proximitysensors 820, the one or more proximity sensors coupled to theillumination system to determine whether a right eye or a left eye ofthe subject is being examined by detecting a cheek or a node of asubject. In some embodiments, a fixation beam may traverse a rangingbeam 715 at an angle and wherein the angle is more than an angle betweenthe MCD 605 and the topography PCB 720.

FIG. 8A illustrates that a corneal topography system as in FIG. 8 mayrotate about a pivot axis in order to examine both eyes of a patientaccording to some embodiments. FIG. 8B illustrates the cornealtopography system as in FIGS. 8 and 8A mounted on a slit lamp microscopeaccording to some embodiments. In some embodiments, a method ofoperating a corneal topography system that is mounted onto a slit lampmicroscope a positioning hole such as a universal positioning hole isdescribed herein. In some embodiments, the mobile communicationdevice-based corneal topography system, which is attached, mounted on orconnected to a hole or opening in the slit-lamp microscope, does notsubstantially change a spatial relationship between the examiner and thepatient. In other words, the examiner still feels comfortable utilizingthe mobile communication device-based corneal topography system becausethe space between and orientation with respect to the patient andmedical examiner is about the same.

In some embodiments, a positioning post as described herein may beutilized to connect to a slit lamp microscope mounting assembly. Inembodiments, a mobile communication device-based corneal topographysystem may be attached (or piggy-backed) onto a slit-lamp microscope inorder to maintain examination accuracy. With reference to FIG. 8A, insome embodiments the Z axis of the topography system comprises theoptical axis of the light pattern, (e.g. the placido disk or concentricrings pattern or illumination pattern), and the optical axis of theimaging system. In embodiments, a corneal topography system may rely on+/−100 micron z-axis positional accuracy in order to have +/−0.25Diopter accuracy in calculating accurate corneal power. In someembodiments, a mobile computing device-based corneal topography systemmay be attached to a slit-lamp microscope and may utilize the slit-lampmicroscope's built-in and existing x-y-z positioning system, where aroller-track and a joystick provides fine motor control of x-y-zpositioning. FIG. 8A illustrates a mobile-computing device-based cornealtopography system configured to placed on a mounting hole within anavailable space of a slit lamp microscope according to some embodiments.As illustrated in FIGS. 8A and 8B, a user or examiner may utilize ajoystick 855 for fine motor control of x-y-z positioning of the coupledor connected mobile computing device-based corneal topography system. Insome embodiments, the joystick 855, may move the slit lamp microscope(and thus the connected mobile communication device 857 and cornealtopography optical housing 852). The use of a slit-lamp microscope inthe mobile computing device-based corneal topography system takesadvantage of the fact that many eye care professionals are alreadytrained in and experienced with use of a slit-lamp microscope.

In some embodiments, a corneal topography system may be picked up. Insome embodiments, a support post of the corneal topography system may beplaced or inserted into a positioning hole such as a universalpositioning hole of a slit-lamp microscope. In some embodiments, thecorneal topography system may be pivoted in a first direction in thepositioning hole to align an eye cup of the corneal topography systemwith a first cornea of a patient. In some embodiments, the cornealtopography system may capture an image of an illuminated pattern on thefirst cornea of the patient. In some embodiments, the corneal topographysystem may be pivoted in a second direction in the positioning hole toalign the eye cup with a second cornea of the patient. In someembodiments, the corneal topography system may capture an image of anilluminated pattern on the second cornea of the patient. FIG. 8Aillustrates a vertical pivot axis 850 running through a positioning post810 and shows that the corneal topography system may rotate about thevertical axis in a first direction and/or a second direction. FIG. 8Billustrates a mobile communication device-based corneal topographysystem mounted on a slit lamp microscope In some embodiments, the slitlamp microscope may include a slit lamp 860, one or more slit lamplenses 859, a slit lamp arm 858, a slit lamp base 856, a joystick 855,and an assembly 854 comprising a positioning hole to receive the post810. In some embodiments, the pivot axis 850 may be a substantiallyvertical axis, e.g. within +/−10 degrees of vertical. In someembodiments, the mobile communication device-based corneal topographysystem may rotate in a left direction and/or a right direction about thepivot axis 850 in order to perform examinations on both eyes of thepatient. In some embodiments, the mobile communication device-basedcorneal topography system may include an assembly 853 comprisingpositioning post 810, an eye cup 851, a housing 852 and/or a mobilecommunication device 857. In some embodiments assembly 853 is configuredto engage assembly 854 with the post receiving in the positioning hole.Each of these assemblies may comprise a bearing surface configured toengage the other assembly when the post has been placed in thepositioning hole. In some embodiments, the eye cup 851 may be on oneside of the pivot axis 850 and the slim lamp lenses 859 and/or slit lamp860 may be on another side of the pivot axis 850. In some embodiments,other components of the mobile communication device-based cornealtopography system (e.g., the mobile communication device 857, an imagesensor and/or portions of an imaging system) may be on an opposite sideof the pivot axis 850 from the eye cup 851. In some embodiments, the eyecup 851 may be on a side of the pivot axis where the patient is located.

In some embodiments, a corneal topography system may include anillumination system configured to generate an illumination patternreflected off a cornea of a subject, an imaging system coupled to animage sensor to capture an image of the reflected illumination pattern,a topography processor operatively coupled to the image sensor toprocess the image of the reflected illumination pattern and a mobilecommunication device. In some embodiments, the mobile communicationsdevice may includes a display, a mobile communication device processorand may be operatively coupled to the image sensor. In some embodiments,the housing at least partially enclosing one or more of the illuminationsystem, the imaging system, or the topography processor. In someembodiments, the corneal topography system may further include amounting or positioning post 853 coupled to the housing, the mountingpost configured to be placed in a positioning hole 854 (e.g., theuniversal positioning hole) of a slit lamp microscope. In someembodiments, the positioning hole may include a universal positioninghole of approximately 8 mm diameter. In some embodiments, thepositioning post may be configured to support the illumination system,the imaging system, the topography processor and/or the mobilecommunication device when placed in the universal positioning hole 854.In some embodiments, the positioning or mounting post 853 may be lessthan 8 mm in diameter. In some embodiments, the corneal topographyhousing may maintain position in the universal positioning hole 854 dueto gravity. In some embodiments, the post may also maintain a positionin the positioning hole via a fit of the positioning hole relative tothe post (e.g., a snug fit or a tight fit), which allows the housing tomaintain vertical alignment with decreased tilt and/or yaw. In someembodiments, the housing and the mounting or positioning post 853 may beconfigured to be able to pivot side to side about a vertical axisextending through a center of the universal positioning hole. In someembodiments, the imaging system may include an eye cup 851 where an eyeis placed during examination, the eye cup 851 positioned ahead of thepositioning hole 854 of the slit-lamp microscope and toward the patientrelative to the positioning hole 854.

In some embodiments, the slit-lamp microscope may include lenses 859,the lenses 859 being on an opposite side of the universal positioninghole 854 from the eye cup 851. In some embodiments, the eye cup 851 maybe located toward the patient relative to the positioning hole 854 andthe lenses 859 of slit lamp patient may be located away from thepositioning hole 854 relative to the patient. In some embodiments, theimage sensor, the topography processor and the mobile communicationdevice 857 may be positioned on the opposite side of the pivot point oraxis 850 from the eye cup 851. In some embodiments, the eye cup 851 maymove in an opposite direction from the image sensor, the topographyprocessor and a display of the mobile communication device 857 when theeye cup 851 pivots about the pivot point or pivot axis 850.

In some embodiments, the corneal topography system may pivot in a rangeof 0.1 to 20 degrees in the first direction from a center of theuniversal positioning hole 854; optionally in a range of 0.1 to 40degrees in the first horizontal direction from the center of theuniversal positioning hole; or optionally in a range of 0.1 to 60degrees in the first horizontal direction from the universal positioninghole 854. In some embodiments, the corneal topography system pivots in arange of 0.1 to 20 degrees in the second direction from a center of theuniversal positioning hole 854; optionally in a range of 0.1 to 40degrees in the second direction from a center of the universalpositioning hole 854; or optionally in a range of 0.1 to 60 degrees inthe second direction from a center of the universal positioning hole854. In some embodiments, the first direction may be opposite the seconddirection. In some embodiments, the pivot in the first direction and thepivot in the second direction are about a substantially vertical axis.In some embodiments, the substantially vertical axis is within about 10degrees of vertical.

In some embodiments, a diameter of the positioning post may be within arange of 7.5 millimeters to 8.5 millimeters; optionally may be fromwithin a range from 7.75 mm to 8.25 mm; optionally may be within a range7.8 millimeters to 8 millimeters; or optionally may be within a range of7.9 millimeters to 8 millimeters.

In some embodiments, the corneal topography system may also includeadditional modules or subsystems in order to perform multiple diagnostictests on a patient's eyes. This brings at least some of the benefitsdescribed including, but not limited to portability, ease of use, lowercost and the ability to reach additional patients. In other words, thehousing of the mobile communication device-based corneal topographysystem or the corneal topography system may also include other eye orcornea diagnostic modules. In some embodiments, the corneal topographysystem may also include an autorefractor module to performautorefraction on a left eye and a right eye of the patient. In someembodiments, the autorefractor module may be configured to pivot aboutthe positioning post along with the eyecup of the corneal topographysystem in order to examine both the left eye and the right eye of thepatient. In some embodiments, the corneal topography system may includea wavefront sensor module to identify aberrations in a left eye and aright eye of the patient. In some embodiments, the wavefront sensormodule may be configured to pivot about the positioning post with theeye cup of the corneal topography system in order to examine both theleft eye and the right eye of the patient. In some embodiments, thecorneal topography system may include a fundus camera module to capturean image of a retina of a patient's left eye and right eye. In someembodiments, the fundus camera may be configured to pivot about thepositioning post with the eyecup of the corneal topography system inorder to examine both the left eye and the right eye of the patient. Insome embodiments, the corneal topography system may include aScheimpflug camera or corneal tomography module to capture images of acornea of a patient's left eye and right eye. In some embodiments, theScheimpflug camera or corneal tomography module may be configured topivot about the positioning post with the eyecup of the cornealtopography system in order to examine both the left eye and the righteye of the patient. In some embodiments, the corneal topography systemmay include a laser interferometer module to capture intraocular lens(IOL) power calculations of a patient's left eye and a right eye. Insome embodiments, the laser interferometer may be configured to pivotabout the positioning post with the eyecup of the corneal topographysystem in order to examine both the left eye and the right eye of thepatient.

In some embodiments, other modules or systems may be placed into thepositioning hole of the slit lamp microscope like the corneal topographysystem described herein and/or may have mobile communication devicesmounted to surfaces thereof. This allows an eye doctor to be able toutilize the slit lamp microscope to perform a number of eye examinationswithout having to purchase additional special equipment. In someembodiments, after the corneal topography system has performeddiagnostic examinations of the right eye and the left eye, the cornealtopography system may be removed from the positioning hole of the slitlamp microscope. In some embodiments, a mobile communicationdevice-based autorefractor system, a mobile communication device-basedcorneal tomography system, a mobile communication device-basedScheimpflug system, a mobile communication device-based wavefront sensorsystem, a mobile communication device-based fundus camera system, and/ora mobile communication device-based laser interferometer system may belifted. In some embodiments, a mounting post of the mobile communicationdevice-based autorefractor system, the mobile communication device-basedcorneal tomography system, the mobile communication device-basedwavefront sensor system, a mobile communication device-based Scheimpflugsystem, the mobile communication device-based fundus camera system, orthe mobile communication device-based laser interferometer system may beplaced in the universal positioning hole of the slit lamp microscope inorder for examinations to be performed on the patient's left eye and theright eye. In some embodiments, this may continue for multiplemobile-communication device eye examination systems that utilize thesame platform for mounting and thus can be easily removed if a differentexamination is requested.

In some embodiments, a topography processor may be configured togenerate topography data and derived topography data. In someembodiments, the mobile communication device to communicate thegenerated topography data and the derived topography data to acloud-based computing device. In some embodiments, the mobilecommunication device to communicate the image of the reflectedillumination pattern to the cloud-based computing device. In someembodiments, the examiner looks down at an angle from horizontal withina range of 2.5 degrees to 15 degrees towards a display of the mobilecommunication device in the mobile communication device-cornealtopography system, or optionally within a range of 5 degrees to 10degrees towards a display of the mobile communication device.

In some embodiments, the eye cup 851 may be located toward the patientfrom the mounting post to allow an angle of the eye cup 851 to change inresponse to anatomical differences between a left eye and a right eye ofa patient. In some embodiments, the slit lamp microscope may include aslit lamp base, the slit lamp base 856 coupled to the hole and lenses ofthe slit lamp. In some embodiments, the slit lamp base 856 includes ajoy stick 855 configured to translate the hole of the slit lamp alongtwo directions with pivoting of the joy stick along two correspondingdirections and wherein rotation of the joystick about an elongate axisof the joystick raises or lowers the hole of the slit lamp microscope.

As detailed above, the computing devices and systems described and/orillustrated herein broadly represent any type or form of computingdevice or system capable of executing computer-readable instructions,such as those contained within the modules described herein. In theirmost basic configuration, these computing device(s) may each comprise atleast one memory device and at least one physical processor.

The term “memory” or “memory device,” as used herein, generallyrepresents any type or form of volatile or non-volatile storage deviceor medium capable of storing data and/or computer-readable instructions.In one example, a memory device may store, load, and/or maintain one ormore of the modules described herein. Examples of memory devicescomprise, without limitation, Random Access Memory (RAM), Read OnlyMemory (ROM), flash memory, Hard Disk Drives (HDDs), Solid-State Drives(SSDs), optical disk drives, caches, variations or combinations of oneor more of the same, or any other suitable storage memory.

In addition, the term “processor” or “physical processor,” as usedherein, generally refers to any type or form of hardware-implementedprocessing unit capable of interpreting and/or executingcomputer-readable instructions. In one example, a physical processor mayaccess and/or modify one or more modules stored in the above-describedmemory device. Examples of physical processors comprise, withoutlimitation, microprocessors, microcontrollers, Central Processing Units(CPUs), Field-Programmable Gate Arrays (FPGAs) that implement softcoreprocessors, Application-Specific Integrated Circuits (ASICs), portionsof one or more of the same, variations or combinations of one or more ofthe same, or any other suitable physical processor.

Although illustrated as separate elements, the method steps describedand/or illustrated herein may represent portions of a singleapplication. In addition, in some embodiments one or more of these stepsmay represent or correspond to one or more software applications orprograms that, when executed by a computing device, may cause thecomputing device to perform one or more tasks, such as the method step.

In addition, one or more of the devices described herein may transformdata, physical devices, and/or representations of physical devices fromone form to another. For example, one or more of the devices recitedherein may receive image data of a sample to be transformed, transformthe image data, output a result of the transformation and store theresult of the transformation to produce an output image of the sample.Additionally or alternatively, one or more of the modules recited hereinmay transform a processor, volatile memory, non-volatile memory, and/orany other portion of a physical computing device from one form ofcomputing device to another form of computing device by executing on thecomputing device, storing data on the computing device, and/or otherwiseinteracting with the computing device.

The term “computer-readable medium,” as used herein, generally refers toany form of device, carrier, or medium capable of storing or carryingcomputer-readable instructions. Referrals to instructions refers tocomputer-readable instructions executable by one or more processors inorder to perform functions or actions. The instructions may be stored oncomputer-readable mediums and/or other memory devices. Examples ofcomputer-readable media comprise, without limitation, transmission-typemedia, such as carrier waves, and non-transitory-type media, such asmagnetic-storage media (e.g., hard disk drives, tape drives, and floppydisks), optical-storage media (e.g., Compact Disks (CDs), Digital VideoDisks (DVDs), and BLU-RAY disks), electronic-storage media (e.g.,solid-state drives and flash media), and other distribution systems.

A person of ordinary skill in the art will recognize that any process ormethod disclosed herein can be modified in many ways. The processparameters and sequence of the steps described and/or illustrated hereinare given by way of example only and can be varied as desired. Forexample, while the steps illustrated and/or described herein may beshown or discussed in a particular order, these steps do not necessarilyneed to be performed in the order illustrated or discussed.

The various exemplary methods described and/or illustrated herein mayalso omit one or more of the steps described or illustrated herein orcomprise additional steps in addition to those disclosed. Further, astep of any method as disclosed herein can be combined with any one ormore steps of any other method as disclosed herein.

Unless otherwise noted, the terms “connected to” and “coupled to” (andtheir derivatives), as used in the specification and claims, are to beconstrued as permitting both direct and indirect (i.e., via otherelements or components) connection. In addition, the terms “a” or “an,”as used in the specification and claims, are to be construed as meaning“at least one of” Finally, for ease of use, the terms “including” and“having” (and their derivatives), as used in the specification andclaims, are interchangeable with and shall have the same meaning as theword “comprising.

The processor as disclosed herein can be configured with instructions toperform any one or more steps of any method as disclosed herein.

As used herein, the term “or” is used inclusively to refer items in thealternative and in combination.

Embodiments of the present disclosure have been shown and described asset forth herein and are provided by way of example only. One ofordinary skill in the art will recognize numerous adaptations, changes,variations and substitutions without departing from the scope of thepresent disclosure. Several alternatives and combinations of theembodiments disclosed herein may be utilized without departing from thescope of the present disclosure and the inventions disclosed herein.Therefore, the scope of the presently disclosed inventions shall bedefined solely by the scope of the appended claims and the equivalentsthereof.

What is claimed is:
 1. An auto-capture method for use in corneal topography systems, comprising: capturing, at an image sensor, a reflected image of a fixation beam at a first wavelength of light and a ranging beam at a second wavelength of light on a cornea of a subject; communicating the reflected image of the fixation beam and the ranging beam to a topography processor; communicating the reflected image of the fixation beam and the ranging beam to a mobile communication device for display; spectrally analyzing, by the topography processor, the first wavelength of light and the second wavelength of light to determine whether the fixation beam and the ranging beam are overlapping; determining that a fiducial mark in a center of the reflected image is aligned with the fixation beam and the ranging beam; communicating instructions to turn off the ranging beam and the fixation beam; and automatically capturing, at the image sensor, an image of an illumination pattern reflected off the cornea of the subject.
 2. A method to automatically capture a reflected Placido rings image of a patient's cornea comprising: activating a ranging light source to generate a red ranging light beam and a fixation light source to generate a green fixation light beam; adjusting a position of a camera with respect to the patient's cornea; detecting a presence of an orange scatter beam in a video image of the patient's cornea, the orange scatter beam identifying an overlapping of the red ranging beam with the green fixation beam in the video image; deactivating the red ranging beam; illuminating a Placido rings assembly to cause a reflection of a Placido rings image on the patient's cornea; and automatically capturing the reflected Placido rings image.
 3. A corneal topography system for measuring topography of a cornea of an eye, the system comprising: an illumination pattern to reflect from the cornea; a fixation target beam, the fixation target beam defining a fixation target visible to the eye, the fixation target beam comprising a first wavelength of light; an alignment beam focused to a beam waist at a location overlapping with fixation target beam, the alignment beam comprising a second wavelength of light different from the first wavelength of light; a detector to image a reflection of the fixation target beam and the alignment beam from the cornea; and a processor coupled to the detector, the processor configured with instructions to display an image of the eye with a portion of the image showing the fixation target beam overlapping with the alignment beam.
 4. The corneal topography system of claim 3, the processor configured with instructions to illuminate the illumination pattern; automatically capture a reflected illumination pattern; generate one or more topogrpahy data files; and communicate the one or more topography data files and/or the captured image of the reflected illumination pattern to a cloud-based server or remote computing device.
 5. The corneal topography system of claim 3, wherein the alignment beam is configured to overlap with the fixation target beam at a vertex normal of the cornea.
 6. The corneal topography system of claim 3, further comprising an optical tube, wherein the fixation target beam is aligned with an axis of the optical tube, and an alignment beam source coupled to an outside surface of the optical tube and the optical tube including an opening, the opening extending from the outside surface of the optical tube to an inside surface of the optical tube to define an aperture extending therebetween, wherein the alignment beam is transmitted through the aperture to the cornea of the subject.
 7. The corneal topography system of claim 3, the alignment beam travelling along a alignment axis, the fixation target beam travelling along a fixation axis, the alignment axis being at an angle with respect to the fixation axis within a range from 25 to 65 degrees.
 8. The corneal topography system of claim 3, wherein the fixation beam comprises substantially collimated light prior to reflection from the cornea and the image of the fixation beam from an anterior surface of cornea comprises a maximum size across within a range from about 10 μm to about 1 mm and wherein the fixation beam is collimated to within about 5 degrees.
 9. The corneal topography system of claim 3, wherein the alignment beam is focused to the beam waist at a full cone angle within a range from about 1 degree to about 45 degrees.
 10. The corneal topography system of claim 3, wherein the image sensor detector comprises an array of pixels, the array comprising a first plurality of pixels more sensitive to the first wavelength than the second wavelength and a second plurality of pixels more sensitive to the second wavelength than the first wavelength.
 11. The corneal topography system of claim 3, wherein the first wavelength comprises a first color and the second wavelength comprises a second color different from the first color and the processor is configured with instructions to display a portion where the first beam overlaps with the second beam with a different color than the first wavelength and the second wavelength.
 12. The corneal topography system of claim 3, wherein the image of an alignment beam comprises an image of scattered light from the cornea when a tear film covers the cornea and.
 13. The corneal topography system of claim 3, wherein an alignment beam source is coupled to an outside surface of an illumination component or optical tube at a position between 1 o'clock and 5 o'clock with respect to vertical.
 14. The corneal topography system of claim 3, wherein a housing encloses an alignment beam source, a fixation beam source, and an imaging system. 